关键词: 全子宫双附件切除 , 腹腔镜, 经阴道取标本, 结直肠癌

Abstract:

Objective To investigate the safety and feasibility of transvaginal extraction of the specimen in laparoscopic sigmoidectomy or protectomy combined with total hysterectomy and bilateral adnexectomy for colorectal cancer. Methods From January 2000 to December 2014，36 cases of sigmoid colon or rectal cancer were undergone laparoscopic sigmoidectomy or protectomy combined with total hysterectomy and bilateral adnexectomy in which the specimen were extracted by vagina. Results No patients needed open conversion. Mean operative time was（173±13）min. Mean amount of blood loss was （80±12）ml. No patients needed painkillers post operation. The mean VAS score was（2.9±1.0）. Mean time of anal flatus was （82±18） h. Mean time of postoperative hospital stay was（6.9±1.8）d. The rate of complication was 31%（11/36），including anastomotic fistula in one case ，vaginal stump fistula in one case ，rectalvaginal fistula in two cases ，early postoperative inflammatory intestinal obstruction in 3 cases，urinary retention in 2 cases，pulmonary infection in 2 cases. The median time of follow?up was 53 months （14 ~ 128 m）. The median survival time was 63.95 months. One?year survival rate was 100%，three?year survival rate was 83% and five?year survival rate was 61%. Conclusion Transvaginal extraction of the specimen in laparoscopic sigmoidectomy or protectomy combined with total hysterectomyand bilateral adnexectomy for local advanced colorectal cancer is feasible and safe in surgical procedure.It had not only such advantages as little trauma，quick recovery，but also satisfactory therapeutic effectof oncology in long?term follow?up.

Key words: colorectal cancer, total hysterectomy and bilateral adnexectomy, transvaginal extraction of the specimen, laparoscopy