使用自然腔道标本取出技术行全腹腔镜低位乙状结肠癌和直肠癌切除术
Totally Laparoscopic Resection for Low Sigmoid and Rectal Cancer Using Natural Orifice Specimen Extraction Techniques.
作者信息
Shimizu Hideharu, Adachi Kensuke, Ohtsuka Hideo, Osaka Itaru, Takuma Kunio, Takanishi Kijuro, Matsumoto Jun
机构信息
*Department of Surgery, Tokyo Metropolitan Tama Medical Center, Fuchu †Department of Surgery, Ebara Hospital, Tokyo Metropolitan Health and Medical Treatment Corporation, Ohta-ku ‡Department of Surgery, Tama Hokubu Medical Center, Tokyo Metropolitan Health and Medical Treatment Corporation, Higashi-Murayama, Tokyo, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):e74-e79. doi: 10.1097/SLE.0000000000000438.
BACKGROUND
A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique.
METHODS
From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers. A prospectively maintained database was reviewed to assess the outcomes after surgery.
RESULTS
In total, 40 patients had high anterior resections using transanal specimen extraction, and 32 patients had low anterior resections with transanal pull-through. Eight patients (11%) reported conversion to conventional laparoscopic colorectal resections; anastomotic leakages occurred in 4 patients (5.6%). No mortality or cancer recurrence was observed during 42.5±16.2 months of follow-up.
CONCLUSIONS
One natural orifice specimen extraction technique, known as transanal specimen extraction, has emerged as a promising form of totally laparoscopic surgical intervention for early-stage cancers of the low sigmoid colon and rectum.
背景
腹腔镜检查期间用于标本提取的迷你剖腹术偶尔会导致术后伤口并发症。我们使用自然腔道标本提取技术对早期结直肠癌进行了全腹腔镜切除术。
方法
2008年至2013年，我们对临床I期和IIA期低位乙状结肠癌和直肠癌进行了全腹腔镜切除术。回顾前瞻性维护的数据库以评估手术后的结果。
结果
总共有40例患者采用经肛门标本提取进行高位前切除术，32例患者采用经肛门拖出术进行低位前切除术。8例患者（11%）报告转为传统腹腔镜结直肠癌切除术；4例患者（5.6%）发生吻合口漏。在42.5±16.2个月的随访期间未观察到死亡或癌症复发。
结论
一种自然腔道标本提取技术，即经肛门标本提取，已成为一种有前景的全腹腔镜手术干预方式，用于治疗低位乙状结肠和直肠的早期癌症。
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