CAJ | 학술논문

目的：探讨腹部无辅助切口腹腔镜直肠癌根治术的可行性。方法回顾性分析2011年1月至2013年6月间在河南大学淮河医院接受改良法腹部无辅助切口腹腔镜直肠癌根治术的26例患者的临床资料。按全直肠系膜切除理念清扫淋巴结和游离结直肠后，在距肿瘤远侧2 cm处以直线切割闭合器切断闭合肠管，组织钳夹将游离的远端直肠经肛门外翻拖出后敞开，标本经保护套从肛门拖出，体外切除标本后在腹腔镜引导下完成吻合。结果26例患者手术均获成功。手术时间（126±35） min，术中出血（33±61） ml，清扫淋巴结（17.0±5．6）枚，术后排气时间（2．7±1．3） d，术后住院时间（7．9±2．6） d，术后发生吻合口出血1例。结论腹部无辅助切口腹腔镜直肠癌根治术安全可行。
목적：탐토복부무보조절구복강경직장암근치술적가행성。방법회고성분석2011년1월지2013년6월간재하남대학회하의원접수개량법복부무보조절구복강경직장암근치술적26례환자적림상자료。안전직장계막절제이념청소림파결화유리결직장후，재거종류원측2 cm처이직선절할폐합기절단폐합장관，조직겸협장유리적원단직장경항문외번타출후창개，표본경보호투종항문타출，체외절제표본후재복강경인도하완성문합。결과26례환자수술균획성공。수술시간（126±35） min，술중출혈（33±61） ml，청소림파결（17.0±5．6）매，술후배기시간（2．7±1．3） d，술후주원시간（7．9±2．6） d，술후발생문합구출혈1례。결론복부무보조절구복강경직장암근치술안전가행。
Objective To explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer. Methods Clinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision(TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique. Results The operation time was (126 ±35) min. The intraoperative blood loss was (33 ±61) ml. The number of harvested lymph nodes was 17.0 ±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage. Conclusion Scarless laparoscopic radical resection of rectal cancer is feasible.