CAJ | 학술논문

目的:探讨低位/超低位直肠癌患者接受腹腔镜下经肛门拖出全直肠系膜切除结合双吻合器手术的临床意义.方法:选择于2010年1月至2012年11月间就诊于吉林大学第二医院普通外科疾病诊疗中心的46例低位/超低位直肠癌患者,施行腹腔镜经肛门拖出全直肠系膜切除结合应用双吻合器手术.回顾性分析手术成功率、术后并发症及远期治疗效果.结果:46例手术均获成功,无中转开腹,手术时间平均167 min,出血量平均42 mL.术后切缘病理检查均未见癌细胞,无手术死亡病例,无吻合口瘘及输尿管损伤等严重并发症,平均随访12.6个月,无局部或吻合口复发、戳卡种植转移.结论:施行低位/超低位直肠癌腹腔镜辅助下经肛门拖出全直肠系膜切除结合应用双吻合器具有安全可行的优点,并且能够保证足够的肿瘤远端切缘.
목적:탐토저위/초저위직장암환자접수복강경하경항문타출전직장계막절제결합쌍문합기수술적림상의의.방법:선택우2010년1월지2012년11월간취진우길림대학제이의원보통외과질병진료중심적46례저위/초저위직장암환자,시행복강경경항문타출전직장계막절제결합응용쌍문합기수술.회고성분석수술성공솔、술후병발증급원기치료효과.결과:46례수술균획성공,무중전개복,수술시간평균167 min,출혈량평균42 mL.술후절연병리검사균미견암세포,무수술사망병례,무문합구루급수뇨관손상등엄중병발증,평균수방12.6개월,무국부혹문합구복발、착잡충식전이.결론:시행저위/초저위직장암복강경보조하경항문타출전직장계막절제결합응용쌍문합기구유안전가행적우점,병차능구보증족구적종류원단절연.
Objective: To evaluate the role of laparoscopic transanal pull-through total mesorectal excision with double stapling surgery in patients with low/ultra-low rectal cancer. Methods: A total of 46 patients diagnosed with low/ultralow rectal cancer underwent laparoscopic transanal pull-through total mesorectal excision (TME) with double stapling technique. The data were retrospectively reviewed and analyzed in terms of the success rate, postoperative complications, and long term therapeutic outcome. Results: All operations were successfully accomplished laparoscopically. No conversion to an open procedure was required. The average operative duration was 167 min (range: 145 min to 228 min). The intraoperative blood loss volume was 42 mL (range: 20 mL to 55 mL). No immediate or delayed injury of the urinary duct or other severe intraoperative complications, such as massive hemorrhage of the presacral venous plexus, occurred. No anastomotic stoma fistula was observed during the postoperative period. The average follow-up period was 12.6 mo. No stomal leak, ureteral injury, or trocar implantation metastasis occurred. To date, none of the cases have local recurrence. Conclusion: Laparoscopic transanal pull-through TME with double stapling surgery is a safe and efficient method for treating low and ultra-low rectal cancer. The method allows preservation of a sufficient distal section margin of the tumor.