Abstract:

【Abstract】 Objective To investigate the therapeutic effect and feasibility of double-view laparoscopic-assisted radical resection for patients with rectal cancer. Methods Fifty-eight patients with rectal cancer received radical resection with a lower abdominal midline incision 6 cm in length using double-view laparoscope, which combined direct vision and screen vision so that the advantage of direct vision and laparoscopic operation could be complementary. Results Double-view laparoscopic-assisted operations were successfully completed in all patients..Among them,.49 cases underwent L-Dixon method and 9 cases undervwnt L-Miles' method. Anastomotic leakage was found in 2 patients and the two patiens cured by colostomy plus abdominal drainage and conservative treatment plus abdominal drainage respectively and conservative treatment. Fourty-three of 58 cases were followed up for 6-36 months (mean,18 months), Most of patients had good recovery. Liver metastasis was found in one case and underwent partial liver resection 25 months after surgery. One case was found the local recurrence and multi-metastasis 19 months after operation,but this patient gave up treatment by himself. Conclusion Double-view laparoscopic-assisted radical resection for patients with rectal cancer has definite advantages over traditional laparotomy, such as brighter operative field, more precise anatomy, techneque easier to control, less trauma and rapid recovery.

Key words: Laparoscope, Minimally invasion, Rectal cancer, Radical resection

摘要：

【摘要】 目的 探讨腹腔镜辅助下直肠癌根治术的临床应用价值及可行性。方法 取下腹正中切口,长约6 cm,利用双视腹腔镜设备,采取直视和屏视相结合,发挥直视和腹腔镜操作优势互补的作用,完成直肠癌根治术58例。结果58例均在双视腹腔镜手术设备辅助下完成手术,L-Dixon手术49例,L-Miles 手术9 例。2例患者出现吻合口漏,其中1例由于炎症局限通过引流和保守治疗后恢复。另一例吻合并发盆腔腹腔经行横结肠造瘘及腹腔引流后治愈。43例患者获6个月至3 年随访,平均18个月,恢复良好。1例患者25个月发现肝脏转移再次入院行肝脏部分切除。另1例患者手术后19个月肿瘤复发及多处转移,患者放弃治疗。 结论 应用双视腹腔镜设备辅助下行直肠癌根治术具有手术视野明亮、解剖精细、安全系数高、创伤小、恢复快、技术易于掌握等特点,有广阔的应用前景。

关键词: 腹腔镜, 微创, 直肠癌, 根治术