引用本文:李 杰,周 颖,芮元祎,易 波,宋 博,郑阳春.腹腔镜下结直肠癌标本体内切除经直肠拖出手术的关键操作技巧(附手术视频)[J].中国临床新医学,2019,12(11):1159-1162.
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腹腔镜下结直肠癌标本体内切除经直肠拖出手术的关键操作技巧(附手术视频)
李 杰,周 颖,芮元祎,易 波,宋 博,郑阳春
610041 四川,成都医学院(李 杰,周 颖);610041 成都,四川省肿瘤医院胃肠外科中心(芮元祎,易 波,宋 博,郑阳春)
摘要:
[摘要] 目的 探讨腹腔镜下结直肠癌经自然腔道取标本手术(natural orifice specimen extraction surgery,NOSES)体内切除肿瘤经直肠拖出技术的关键操作技巧。方法 对四川省肿瘤医院2017-06~2019-03采用标本体内切除经直肠拖出方式完成腹腔镜结直肠癌NOSES手术的29例患者的临床资料和术中操作技巧进行分析总结。结果 29例患者平均手术时间为(252.0±57.7)min,术中出血量为(44.6±20.8)ml,术后肛门排气时间为(20.7±9.2)h,住院时间为(10.7±2.5)d。术中无一例发生腹腔污染,术后所有患者恢复良好,无一例发生吻合口瘘。随访至2019-10,无一例发现肿瘤复发或转移。结论 腹腔镜下结直肠癌NOSES标本体内切除经直肠拖出手术安全可行,术中严格遵守无菌和无瘤原则,熟练掌握相关操作技巧是保证手术成功的关键。
关键词:  腹腔镜手术  结直肠癌  经自然腔道取标本手术  操作技巧
DOI:10.3969/j.issn.1674-3806.2019.11.03
分类号:R 735.3
基金项目:四川省科技厅创新团队资助课题(编号:2017TD0029)
The key operation skills of successful laparoscopic resection of colorectal cancer with specimen resection and dragging-out removal per anus and rectum(with video)
LI Jie, ZHOU Ying, RUI Yuan-yi, et al.
Chengdu Medical College, Sichuan 610041, China
Abstract:
[Abstract] Objective To explore the key operation skills of laparoscopic natural orifice specimen extraction surgery(NOSES) for colorectal cancer by resection of the tumor inside the body and dragging-out removal per anus and rectum. Methods The clinical data of the colorectal cancer patients receiving laparoscopic NOSES for resection of the tumors inside the body and dragging-out removal per anus and rectum from June 2017 to March 2019 in Sichuan Cancer Hospital and the intra-operative surgical skills were retrospectively analyzed and summarized. Results All the 29 patients underwent successful surgery, with average operative time of (252.0±57.7)minutes, intraoperative bleeding volume of (44.6±20.8)milliliters, postoperative exhausting time of (20.7±9.2)hours, and hospital stay of (10.7±2.5)days. No abdominal contamination occurred during operation. All the patients recovered smoothly after operation, and no anastomotic leakage occurred. All of the patient were followed up until October 2019, none of them had tumor recurrence or metastasis. Conclusion Laparoscopic NOSES is safe and feasible for treatment of colorectal cancer by means of resection of the tumor inside the body and dragging-out removal per anus and rectum. Observing the principles of asepsis and tumor-free strictly and mastering the key manipulation skills are the key points to guarantee the success of the operation.
Key words:  Laparoscopic surgery  Colorectal cancer  Natural orifice specimen extraction surgery(NOSES)  Operation skills