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目的:探讨腹部无切口的腹腔镜直肠癌根治术的可行性与疗效。方法:回顾性分析47例腹部无切口的腹腔镜直肠癌根治术患者的临床资料,对手术的可行性、安全性、根治性等进行评价。结果:47例手术均获成功,无中转术式,无严重术中、术后并发症,无手术相关死亡。手术平均时间140(90～210)min,平均失血110(50～350)ml。术后平均留置导尿时间10(7～15)d,平均住院日14(10～21)d,所有患者3个月后排便控便功能均良好。平均清扫淋巴结14(8～24)枚,28例低位直肠癌平均远切缘1.8(1～4)cm,无切缘阳性病例。结论:经自然腔道取出标本的腹腔镜直肠癌根治术安全可行,同时具有腹部创口最小化,降低直肠低位横断难度等优点。
Objective: To investigate the feasibility and efficacy of laparoscopic radical resection of abdominal incision without incision. Methods: The clinical data of 47 patients undergoing laparoscopic radical resection of laparoscopic rectal cancer without abdominal incision were retrospectively analyzed. The feasibility, safety and curative effect were evaluated. Results: All the 47 surgeries were successful. There was no transfer operation, no severe intraoperative and postoperative complications, and no operative death. The average operation time was 140 (90 ~ 210) min, and the average blood loss was 110 (50 ~ 350) ml. Postoperative average catheterization catheterization time 10 (7 ~ 15) d, the average length of stay 14 (10 ~ 21) d, all patients 3 months after the defecation control of bowel function were good. The average dissection lymph nodes 14 (8 ~ 24) pieces, 28 cases of low rectal cancer, the average distal margin of 1.8 (1 ~ 4) cm, no case of positive margins. CONCLUSION: Laparoscopic radical resection of the rectum with natural laparotomy is safe and feasible. At the same time, it has the advantages of minimal abdominal incision and reducing the difficulty of transection of the lower rectum.