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目的:探讨腹腔镜联合内窥镜在早期结肠癌治疗中的应用价值。方法:回顾性分析我研究所2002年3月至2007年12月应用双镜联合治疗55例早期结肠癌患者的临床资料。结果:55例双镜联合治疗患者,根据术前电子肠镜活检病理结果,先行内窥镜定位腹腔镜游离结肠肠段切除术,术中切除标本送检快速冰冻切片病理检查,结果证实11例癌肿浸润至黏膜下层,均追加腹腔镜结肠癌根治术,其中2例伴有区域淋巴结转移,术后给予常规辅助化疗。中转开腹手术2例,无术后并发症。术后借助我所随访管理辅助信息系统,所有病例均获长期随访,除1例术后1年死于心肌梗死外,其余患者存活至今,平均随访42个月(3~72个月),均未见任何复发转移。结论:双镜联合应用,对病灶定位准确,减少了手术创伤。术中应用快速冰冻切片病理检查,增加了治疗的安全性,对于内窥镜下切除风险较大或内窥镜下切除术后仍有癌组织残留的早期结肠癌,双镜联合手术是有效治疗方法之一。
Objective: To investigate the value of laparoscopic combined endoscopy in the treatment of early colon cancer. Methods: The clinical data of 55 patients with early stage colon cancer treated by double mirror combined treatment from March 2002 to December 2007 in our institute were retrospectively analyzed. Results: According to the results of preoperative electron colonoscopy biopsy, 55 cases of double-mirror combined treatment were treated with laparoscopic free colon and bowel resection and resected specimens were collected for rapid frozen section biopsy. The results showed that 11 cases Invasion of cancer to the submucosa, are additional laparoscopic radical mastectomy, including 2 cases with regional lymph node metastasis, postoperative conventional adjuvant chemotherapy. 2 cases underwent laparotomy without complications. All the patients were followed up for a long term. All patients were followed up for a long time. One patient died of myocardial infarction at one year after operation. The other patients survived till now with an average follow-up of 42 months (range, 3-72 months) No recurrence and metastasis. Conclusion: The combination of double mirror, accurate positioning of the lesion, reducing the surgical trauma. Rapid intraoperative frozen section biopsy, increased the safety of treatment, for endoscopic resection of the larger risk of endoscopic resectomy or residual cancer of early colon cancer, double mirror surgery is effective One of the ways.