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目的探讨腹腔镜辅助结直肠肿瘤切除的手术方法和疗效。方法运用腹腔镜技术治疗结直肠肿瘤28例,其中右半结肠切除9例、横结肠癌根治术1例、Dixon手术9例、Miles手术3例、乙状结肠切除术3例,左半结肠切除术3例。观察并记录手术时间、出血量、并发症、肠功能恢复时间、住院时间等指标。结果 22例顺利完成腹腔镜辅助右半结肠癌根治术,3例中转开腹(其中1例因肿瘤侵犯十二指肠,2例回盲部肿瘤>8cm),3例因广泛转移仅行开关腹手术,无手术死亡。平均手术时间155(130～250)min,平均出血量140(50～180)ml,平均术后住院天数9.4(7～13)d。1例术后3d发现肺部感染,1例术后第4天出现不完全性肠梗阻,经对症处理后好转。结论腹腔镜辅助下结直肠肿瘤手术损伤小、安全可行,熟练的腔镜技术和手术经验有助于提高手术成功率。
Objective To investigate the surgical method and efficacy of laparoscopic assisted colorectal tumor resection. Methods 28 cases of colorectal cancer were treated by laparoscopy. Among them, 9 cases were treated with right colon resection, 1 case with transverse colon cancer, 9 cases with Dixon operation, 3 cases with Miles operation, 3 cases with sigmoid colon resection, 3 cases with left colon resection . Observe and record the operation time, blood loss, complications, recovery time of intestinal function, hospitalization time and other indicators. Results Twenty-two patients successfully completed laparoscopic-assisted radical resection of the right colon cancer, 3 were converted to open surgery (1 invaded the duodenum and 2 in the ileocecal tumor> 8 cm), and only 3 of them were switched by extensive metastasis Abdominal surgery, no operative death. The average operation time was 155 (130 ~ 250) min and the average amount of bleeding was 140 (50 ~ 180) ml. The average postoperative hospital stay was 9.4 (7 ~ 13) days. One case of lung infection after 3 days found, 1 case of incomplete intestinal obstruction after 4 days, after the symptomatic treatment improved. Conclusions Laparoscopic assisted colorectal cancer surgery is less invasive, safe and feasible, and skilled endoscopic techniques and surgical experience help to improve the success rate of surgery.