van der Linden Yoen Tk, Boersma Doeke, Bosscha Koop, Lips Daniel J, Prins Hubert A
Department of Surgery, Jeroen Bosch Medical Center, 's-Hertogenbosch, The Netherlands.
J Minim Access Surg. 2016 Jul-Sep;12(3):248-53. doi: 10.4103/0972-9941.181386.
Laparoscopic colorectal surgery results in less post-operative pain, faster recovery, shorter length of stay and reduced morbidity compared with open procedures. Less or minimally invasive techniques have been developed to further minimise surgical trauma and to decrease the size and number of incisions. This study describes the safety and feasibility of using an umbilical multi-instrument access (MIA) port (Olympus TriPort+) device with the placement of just one 12-mm suprapubic trocar in laparoscopic (double-port) abdominoperineal resections (APRs) in rectal cancer patients.
The study included 20 patients undergoing double-port APRs for rectal cancer between June 2011 and August 2013. Preoperative data were gathered in a prospective database, and post-operative data were collected retrospectively.
The 20 patients (30% female) had a median age of 67 years (range 46-80 years), and their median body mass index (BMI) was 26 kg/m2 (range 20-31 kg/m2). An additional third trocar was placed in 2 patients. No laparoscopic procedures were converted to an open procedure. Median operating time was 195 min (range 115-306 min). A radical resection (R0 resection) was achieved in all patients, with a median of 14 lymph nodes harvested. Median length of stay was 8 days (range 5-43 days).
Laparoscopic APR using a MIA trocar is a feasible and safe procedure. A MIA port might be of benefit as an extra option in the toolbox of the laparoscopic surgeon to further minimise surgical trauma.
与开放手术相比，腹腔镜结直肠手术术后疼痛更少、恢复更快、住院时间更短且发病率更低。已经开发出更少或微创技术以进一步减少手术创伤并减少切口的大小和数量。本研究描述了在直肠癌患者的腹腔镜（双端口）腹会阴联合切除术（APR）中使用脐部多器械接入（MIA）端口（奥林巴斯TriPort+）设备并仅放置一个12毫米耻骨上套管针的安全性和可行性。
该研究纳入了2011年6月至2013年8月间接受双端口直肠癌APR手术的20例患者。术前数据收集于前瞻性数据库，术后数据进行回顾性收集。
20例患者（30%为女性）的中位年龄为67岁（范围46 - 80岁），中位体重指数（BMI）为26 kg/m²（范围20 - 31 kg/m²）。2例患者额外放置了第三个套管针。无腹腔镜手术转为开放手术。中位手术时间为195分钟（范围115 - 306分钟）。所有患者均实现了根治性切除（R0切除），中位清扫淋巴结数为14枚。中位住院时间为8天（范围5 - 43天）。
使用MIA套管针进行腹腔镜APR是一种可行且安全的手术。MIA端口作为腹腔镜外科医生工具库中的额外选择，可能有助于进一步减少手术创伤。
