3D腹腔镜治疗胃肠肿瘤44例临床分析

doi:10.3877/cma.j.issn.1674-0793.2015.05.010

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (05) : 369 -372. doi: 10.3877/cma.j.issn.1674-0793.2015.05.010

所属专题：经典病例；文献；

论著

3D腹腔镜治疗胃肠肿瘤44例临床分析

黄江龙¹, 郑宗珩¹, 刘健培¹, 魏波¹, 陈图锋¹, 黄勇¹, 方佳峰¹, 卫洪波¹^,^†(

)

^1. 510630　广州，中山大学附属第三医院胃肠外科

收稿日期:2015-05-11 出版日期:2015-10-01
通信作者: 卫洪波
基金资助:
广东省科技计划项产学研合作项目(2014B090901066); 广州市产学研协同创新重大专项项目(2060404); 广东省医学科研基金资助项目(B2013127)

Application of 3D laparoscopy techniques in gastrointestinal tumor: a report of 44 cases

Jianglong Huang¹, Zongheng Zheng¹, Jianpei Liu¹, Bo Wei¹, Tufeng Chen¹, Yong Huang¹, Jiafeng Fang¹, Hongbo Wei¹^,^†()

^1. Department of Gastrointestinal Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Received:2015-05-11 Published:2015-10-01
Corresponding author: Hongbo Wei
About author:
Corresponding author: Wei Hongbo, Email: drweihb@126.com

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目的

探讨3D腹腔镜在胃肠肿瘤手术中的应用。

方法

回顾性分析2013年10月至2015年6月应用Olympus 3D腹腔镜系统完成手术44例的临床资料,其中右半结肠切除术12例,左半结肠切除3例,乙状结肠切除11例,低位直肠前切除术10例,远端胃癌根治术8例,统计分析手术时间、出血量、术后住院时间等数据。

结果

44例胃肠肿瘤腹腔镜手术均获成功,无中转开腹。手术时间为(173.52±48.65) min,术中出血量为(71.59±35.17) ml,术后住院时间为(8.66±2.21) d。

结论

3D腹腔镜成像系统还原了三维立体手术视野,手术解剖更精细,从而减少手术并发症发生,降低手术难度,缩短手术时间,具有腹腔镜和开腹的优势,适合更复杂的腹腔镜手术。

关键词: 3D腹腔镜, 胃肠肿瘤, 手术时间, 出血量

Objective

To explore the application of 3D imaging system in gastrointestinal tumor operation.

Methods

From October 2013 to June 2015, a total of forty-four cases of Olympus 3D laparoscopic surgeries were enrolled in the study including 12 cases of right hemicolectomy, 3 cases of left hemicolectomy, 11 cases of sigmoidectomy, 10 cases of low anterior resection for rectal cancer, and 8 cases of distal gastrectomy. The data of operative time, blood loss, and postoperative hospital stay were collected.

Results

The 3D laparoscopic surgeries were carried out successfully. No patient was converted to conventional operation. The mean time of surgery was (173.52±48.65) min, the intraoperative blood loss was (71.59±35.17) ml, and the mean postoperative hospital stay was (8.66±2.21) d.

Conclusion

3D imaging system can provide clearly 3D visual operative field and more precise operation with reduced complications, and helps to decrease the operation difficulty and time. The system has the superiorities of both laparoscope and open surgery, and is suitable for more complex laparoscopic surgery.

Key words: 3D laparoscope, Gastrointestinal tumor, Operative time, Blood loss

图1 结扎回结肠静脉

图2 结扎结肠中动脉右侧分支

图3 进入右侧Toldt’s间隙

图4 解剖肠系膜下动脉

表1 44例行3D腹腔镜手术的胃肠肿瘤患者手术情况( ± s)

手术方式	例数	手术时间(min)	术中出血(ml)	术后住院时间(d)
右半结肠切除术	12	175.83±16.35	78.33±22.90	8.17±1.27
左半结肠切除术	3	148.33±12.58	63.33±15.28	9.0±1.73
乙状结肠切除术	11	136.82±25.91	41.82±14.01	7.91±2.34
低位直肠前切除术	10	152.5±30.30	71±24.24	8.6±2.50
根治性远端胃大部分切除术	8	256.25±32.92	106.25±52.90	10.38±2.45
合计	44	173.52±48.65	71.59±35.17	8.66±2.21

表1 44例行3D腹腔镜手术的胃肠肿瘤患者手术情况( ± s)

手术方式	例数	手术时间(min)	术中出血(ml)	术后住院时间(d)
右半结肠切除术	12	175.83±16.35	78.33±22.90	8.17±1.27
左半结肠切除术	3	148.33±12.58	63.33±15.28	9.0±1.73
乙状结肠切除术	11	136.82±25.91	41.82±14.01	7.91±2.34
低位直肠前切除术	10	152.5±30.30	71±24.24	8.6±2.50
根治性远端胃大部分切除术	8	256.25±32.92	106.25±52.90	10.38±2.45
合计	44	173.52±48.65	71.59±35.17	8.66±2.21

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