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目的总结减孔腹腔镜直肠前切除在中高位直肠癌根治术中应用的经验,对此技术的操作流程及特点进行讨论。方法 2014年3月至2014年9月间郑州大学附属肿瘤医院普外科行减孔腹腔镜直肠前切除术治疗10例中高位直肠癌。取脐下切口约3cm通过自制单孔通道置入2个5mm穿刺器和1个10mm穿刺器,另右下腹置入12mm穿刺器,行减孔腹腔镜直肠前切除术,切除标本经脐下切口取出,经右下腹穿刺器口置入引流管1根。结果 10例手术均顺利完成,无中转开腹病例。手术平均时间152.5min,术中平均失血量37.5ml,平均切口长度3.6cm,术后肛门排气时间2.24d,术后平均住院天数8.8d,术后平均淋巴结数17枚。其中1例术后出现吻合口瘘,经引流管冲洗通畅引流治愈。所有病例均恢复良好。结论减孔腹腔镜直肠切除术治疗中高位直肠癌是安全可行的。
Objective To summarize the experience of mitral laparoscopic resection of laparoscopic rectal cancer in the middle and high rectal cancer radical surgery, and discuss the operation flow and characteristics of this technique. Methods From March 2014 to September 2014, 10 cases of middle and high rectal cancer were treated by modified parathoscope and laparoscopic anterior resection in general surgery department of Affiliated Tumor Hospital of Zhengzhou University. Take the incision about 3cm under the umbilicus through the home-made single-hole channel into two 5mm puncture and a 10mm puncture, and the other right lower quadrant into the 12mm trocar, line reduction laparoscopic anterior resection, resection of the specimen through the incision Remove, the right lower quadrant puncture port into the drainage tube 1 root. Results All the 10 surgeries were successfully completed without conversion to laparotomy. The average operation time was 152.5 minutes. The mean intraoperative blood loss was 37.5ml. The mean length of incision was 3.6cm. The time of postoperative anal exhaust was 2.24 days. The average postoperative hospital stay was 8.8 days. The average number of postoperative lymph nodes was 17. One case of anastomotic fistula occurred after surgery, drainage tube drainage drainage cure. All cases recovered well. Conclusions LAP laparoscopic rectal resection for middle and high rectal cancer is safe and feasible.