Consorcio Sanitario Publico del Aljarafe, Hospital San Juan de Dios, Bormujos, Sevilla, Spain.
Department of Laparoscopic Surgery, Minimally Invasive Surgery Centre Jesús Usón, Cáceres, Caceres, Spain.
Eur J Surg Oncol. 2014 Jun;40(6):713-8. doi: 10.1016/j.ejso.2014.01.008. Epub 2014 Feb 7.
To investigate the feasibility and safety of laparoscopy-assisted transvaginal resection of sigmoid cancer.
From 2009 to 2011 we performed 21 laparoscopy-assisted transvaginal resections of sigmoid cancers.
The resected tumours were T1(6), T2(7) and T3(8). The median number of resected lymph nodes was 15. Median operative time was 150 min and no conversion to open technique was necessary. A total of eighteen patients tolerated a liquid diet 24 h after surgery. The average VAS pain score (0 = no pain, 10 = unbearable pain) was 1.8 after 24 h and 1.1 after 48 h. One patient experienced a postoperative ileus, two patients had vaginal spotting with serous flow and three patients suffered urinary tract infections. One patient developed a hernia at the umbilical trocar site that was operated on. None of the sexually active patients reported any differences in sexual activity pre-op and postop on a postoperative questionnaire. After a median of 25 (10-41) months of follow-up, all patients are alive and well, with no evidence of recurrent disease.
Laparoscopy-assisted transvaginal resection of sigmoid cancer is feasible and safe in a selected group of patients.
探讨腹腔镜辅助经阴道乙状结肠癌根治术的可行性和安全性。
2009 年至 2011 年，我们对 21 例乙状结肠癌患者实施了腹腔镜辅助经阴道乙状结肠癌根治术。
切除的肿瘤 T1 期（6 例）、T2 期（7 例）和 T3 期（8 例）。中位淋巴结清扫数目为 15 枚。中位手术时间为 150 分钟，无中转开腹。18 例患者术后 24 小时可耐受流质饮食。术后 24 小时平均视觉模拟评分（0 分为无痛，10 分为无法忍受的疼痛）为 1.8，术后 48 小时为 1.1。1 例患者发生术后肠梗阻，2 例患者阴道有血性分泌物，3 例患者发生尿路感染。1 例患者脐部套管部位发生疝，行手术治疗。术后问卷调查显示，所有有性生活的患者均无性生活质量术前和术后的差异。中位随访 25（10-41）个月后，所有患者均存活且状况良好，无疾病复发证据。
在选择的患者中，腹腔镜辅助经阴道乙状结肠癌根治术是可行且安全的。
