[1]戚睿飞 王永强* 胡旭光①.腹腔镜联合结肠镜治疗结肠肿瘤体会[J].中国微创外科杂志,2017,17(3):267-269.
　Qi Ruifei*,Wang Yongqiang*,Hu Xuguang..Experience of Laparoscopy and Colonoscopy Cooperative Surgery in Treatment of Colon Tumors[J].Chinese Journal of Minimally Invasive Surgery,2017,17(3):267-269.
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腹腔镜联合结肠镜治疗结肠肿瘤体会()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年3期
页码:
267-269
栏目:
经验交流
出版日期:
2017-06-20

文章信息/Info

Title:
Experience of Laparoscopy and Colonoscopy Cooperative Surgery in Treatment of Colon Tumors
作者:
戚睿飞 王永强* 胡旭光①
江苏大学附属昆山市第一人民医院肛肠外科，昆山215300
Author(s):
Qi Ruifei*;  Wang Yongqiang*;  Hu Xuguang.
*Department of Colorectal Surgery, Kunshan First People’s Hospital of Jiangsu University, Kunshan 215300, China
关键词:
腹腔镜; 结肠镜; 结肠肿瘤; 定位
Keywords:
Laparoscopy; Colonoscopy; Colon tumor; Positioning
文献标志码:
B
摘要:
目的探讨腹腔镜治疗结肠肿瘤术中应用结肠镜定位的效果。方法2014年1月~2015年11月16例结肠肿瘤行腹腔镜下结肠肿瘤切除术中，因病灶未侵及浆膜层或位于侧腹壁，腹腔镜下不能明确部位及切除范围，术中经肛门行结肠镜定位，利用“透光法”明确病灶部位后行根治性切除。结果16例在结肠镜下均找到病灶，在腹腔镜下标记后切除，无中转开腹，无漏切、误切。手术时间（112.5±31.0）min，术中出血（22.8±11.2）ml。术前9例病理诊断为良性肿瘤中，术后6例病理诊断为恶性肿瘤，其中4例为中分化腺癌，1例为中-重度不典型增生，灶区癌变，1例为中分化腺癌，部分黏液腺癌。15例术后12~14 d痊愈出院，1例因吻合口漏术后1个月痊愈出院。术后3个月随访16例，肠镜检查未发现复发。结论腹腔镜下结肠肿瘤切除术中因病灶部位不能明确，在结肠镜下定位，明确病灶部位，避免漏切、误切的风险，有优势互补的作用，增加腹腔镜手术的适应范围及安全性，值得推广。
Abstract:
ObjectiveTo investigate the result of colonoscopic positioning in laparoscopic treatment of colon tumors. MethodsA retrospective analysis was made in 16 cases of colon tumors treated with laparoscopic colon resection from January 2014 to November 2015. During the operation, the lesion could not be locatized and the resection range could not be determinated because the serous layer was not involved or the lesion was located in the lateral abdominal wall. Transanal colonoscopic positioning of the lesion with light transmission method was carried out. ResultsThe pathological changes were found under colonoscopy in all the 16 cases and the laparoscopic resection was successfully completed without conversion to open operation. No missed resection or incorrect resection occurred. The operation time was (112.5±31.0) min and the blood loss was (22.8±11.2) ml. Among 9 cases of preoperative pathological diagnosis of benign tumors, there were 6 cases of malignant tumors after surgery, including 4 cases of moderately differentiated adenocarcinoma, 1 case of moderate to severe atypical hyperplasia with cancerous lesions, and 1 case of moderately differentiated adenocarcinoma with mucous adenocarcinoma. A total of 15 patients were discharged from hospital at 12-24 days after the operation, whereas 1 patient was dismissed 1 month after the operation due to anastomotic fistula. The 16 patients were followed up for 3 months with no recurrence under colonoscopic examiantion.ConclusionsDuring laparoscopic colon resection, if the tumor can not be locolized, colonoscopic positioning can help prevent missed resection or incorrect resection, which increases the indication and safety of laparoscopic and colonoscopic minimally invasive treatment. It has good clinical application value and deserves further promotion.

参考文献/References:

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备注/Memo

备注/Memo:
*通讯作者,E-mail:wangyongqiang1968@163.com①（上海交通大学医学院附属新华医院肛肠外科，上海200092）
更新日期/Last Update: 2017-06-20