腹腔镜辅助直肠外翻低位直肠癌前切除27例
Pilot Research on Rectal Eversion in Laparoscopic-assisted Low Anterior Resection for Low Rectal Cancer: A Report of 27 Cases
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摘要:目的 遵循直肠癌全直肠系膜切除(Total Mesoreetal Exeision, TME)原则的前提下, 探讨应用腹腔镜辅助直肠外翻技术完成低位直肠癌骶前切除及吻合的新方法。方法 选择性地对2007年6月到2009年7月间收治的27例低位及超低位直肠癌患者实施腹腔镜辅助直肠癌根治术, 术中将远端直肠经肛门外翻来确定肿瘤远端切缘, 完成低位保肛术。结果 所有27例患者手术顺利, 切缘病检阴性, 术后恢复顺利, 无吻合口漏, 随访6~31个月, 26例无瘤生存。结论 将直肠肿物经肛门外翻确定肿瘤远端切割线的方法可以弥补腹腔镜下术者手感不足的缺点, 能够准确地确定直肠远端安全切缘, 同时还可以节省手术费用, 让更多的患者受益于腹腔镜直肠癌手术。Abstract:Objective This study explores a new approach of laparoscopic- assisted low anterior resection for low rectal cancer according to the Total Mosovectal Excicion (TME) principle.Methods The clinical data of 27 selected low or super-low rectal cancer patients, who underwent laparoscopy-assisted low anterior resection and presacral anastomosis through rectal eversion from June 2007 to July 2009 were analyzed retrospectively.Result All 27 patients underwent favorable procedures, obtained negative incisal margin, and smoothly rehabilitated without anastomotic leakage. The results of 6 to 15 months of follow-up indicated that the 26 patients rendered disease-free survival.Conclusion Laparoscopy-assisted radical resection and presacral anastomosis for low or super-low rectal cancer through rectal eversion is a more economical and satisfactory method that can compensate the sensory feedback of laparosco- py-assisted operation and ensure a negative incisal margin.
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