| 摘要: |
| 目的 探讨腹腔镜下切除直肠间质瘤的可行性及安全性。方法 2013年5月-2016年12月在我科接受行腹腔镜直肠间质瘤切除术的患者共16例，其中男性10例、女性6例，肿瘤直径均小于5 cm。肿瘤下缘距肛缘大于5 cm者行腹腔镜下直肠前切除术（Dixon术），肿瘤下缘距肛缘小于5 cm且大于3 cm者行腹腔镜下局部切除术，肿瘤下缘距肛缘小于3 cm且与周边组织界限不清者则行腹腔镜下腹会阴联合切除术（Miles术）。结果 16例直肠间质瘤患者均在腹腔镜下成功切除肿瘤，无一例中转开腹手术，无术后穿孔、出血、梗阻、吻合口漏等并发症发生。其中，12例行腹腔镜下直肠前切除术（Dixon术），3例行腹腔镜下局部切除术，1例行腹腔镜下腹会阴联合切除术（Miles术）。平均手术时间（103.0±23.8） min，平均住院时间（7.0±1.2） d，平均术中出血（14.0±4.1） mL。术后病理证实为间质瘤，切缘阴性。随访8~40个月，无一例患者复发。2例患者肿瘤转移至肝脏，并最终死于肝转移。结论 腹腔镜下直肠间质瘤切除是安全、可行的，手术创伤小，住院时间短，术后恢复快。 |
| 关键词: 直肠肿瘤 间质瘤 腹腔镜检查 微创性外科手术 |
| DOI：10.16781/j.0258-879x.2017.08.1071 |
| 投稿时间：2017-07-10修订日期：2017-08-14 |
| 基金项目: |
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| Laparoscopic surgery for rectal stromal tumor: a report of 16 cases |
| YING Jun,YAO Jun,ZHANG Jian,WANG Zhi-guo,HU Zhi-qian* |
(Department of Surgery (Ⅰ), Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To explore the feasibility and safety of laparoscopic resection for rectal stromal tumor. Methods Sixteen (10 male and 6 female) patients underwent laparoscopic resection of rectal stromal tumor in our department from May 2013 to Dec. 2016, and the tumor diameter of all patients was less than 5 cm. The patients with the distance of more than 5 cm from the lower margin of the tumor to the anal verge received laparoscopic anterior resection of the rectal carcinoma (Dixon), the patients with the distance of less than 5 cm and more than 3 cm received laparoscopic local resection, and the patients with the distance of less than 3 cm, whose tumor boundary with the surrounding tissue were unclear, received laparoscopic abdominal perineal resection (Miles). Results The rectal stromal tumors of 16 cases were successfully removed under laparoscope without conversion to laparotomy, and no post-operative complications such as perforation, bleeding, obstruction or anastomotic leakage occurred. Of 16 cases, 12 underwent laparoscopic anterior resection of the rectal carcinoma (Dixon), 3 underwent laparoscopic local resection, and 1 underwent laparoscopic perineal resection (Miles). The average operation time was (103.0±23.8) min, the average hospital stay was (7.0±1.2) days, and the average volume of intra-operative bleeding was (14±4.1) mL. The pathological findings were confirmed as stromal tumor with negative margin. There was no recurrence during the follow-up of 8 to 40 months. Two cases with the tumor transferring to the liver eventually died of liver metastasis. Conclusion Laparoscopic resection of rectal stromal tumors is safe and feasible, with less trauma, shorter hospitalization time and quicker post-operative recovery. |
| Key words: rectal neoplasms stromal tumors laparoscopy minimally invasive surgical procedures |
