腹腔镜与折刀位在直肠癌根治术中的联合应用(2)
术中的无瘤技术是保证根治的前提，包括了以下多个方面：①坚守肿瘤TME根治切除原则。②脱落癌细胞的预防。③肿瘤非触碰技术。④预防CO2气腹对癌细胞种植的影响；⑤对于术中标本及取出口的保护。我们的部分经验是：组织间隙及解剖结构的清晰，保证了会阴部手术及腹腔镜操作时的肿瘤完整性切除和非触碰原则；荷包缝合肛门及无菌手套包裹则可以严格保护标本，防止肿瘤种植。我们认为腹腔镜Miles术中应用折刀位是安全可行的，且具有优势。
参 考 文 献
[1] The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med, 2004,350(20):20502059.
[2] Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopicassisted resection of colorectal carcinoma: 32 year results of the UKMRC CLASI CC Trial Group. J Clin Oncol, 2007, 25(21):30613068.
[3] 中国抗癌协会大肠癌专业委员会腹腔镜外科学组.中华医学会外科分会腹腔镜与内镜外科学组.腹腔镜结肠直肠癌根治手术操作指南(2006版).外科理论与实践,2006,11(5):462464.
[4] 中国抗癌协会大肠癌专业委员会.中下段直肠癌外科治疗规范(草案).中华胃肠外科杂志,2005,8(1): 8890.
[5] The MRC CLASICC trial group. Shortterm endpoints of conventional versus laparoscopicassisted surgery in patients with colorectal cancer. (MRC CLASICC trial):multicenter, randomized controlled trial. Lancet,2005,365(9472):17181726., 百拇医药(沈长兵 黄海波 秦菊芳 喻刚)
参 考 文 献
[1] The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med, 2004,350(20):20502059.
[2] Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopicassisted resection of colorectal carcinoma: 32 year results of the UKMRC CLASI CC Trial Group. J Clin Oncol, 2007, 25(21):30613068.
[3] 中国抗癌协会大肠癌专业委员会腹腔镜外科学组.中华医学会外科分会腹腔镜与内镜外科学组.腹腔镜结肠直肠癌根治手术操作指南(2006版).外科理论与实践,2006,11(5):462464.
[4] 中国抗癌协会大肠癌专业委员会.中下段直肠癌外科治疗规范(草案).中华胃肠外科杂志,2005,8(1): 8890.
[5] The MRC CLASICC trial group. Shortterm endpoints of conventional versus laparoscopicassisted surgery in patients with colorectal cancer. (MRC CLASICC trial):multicenter, randomized controlled trial. Lancet,2005,365(9472):17181726., 百拇医药(沈长兵 黄海波 秦菊芳 喻刚)