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中华结直肠疾病电子杂志 ›› 2015, Vol. 04 ›› Issue (01) : 26 -31. doi: 10.3877/cma.j.issn.2095-3224.2015.01.06

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青年专家论坛

手辅助腹腔镜结直肠癌根治术的发展、优势与应用
王贵玉1()   
  1. 1. 150086 哈尔滨医科大学附属第二医院结直肠肿瘤外科 哈尔滨医科大学大肠癌研究所
  • 收稿日期:2014-12-17 出版日期:2015-02-25
  • 通信作者: 王贵玉
  • 基金资助:
    哈尔滨医科大学伍连德青年科学基金(WLD-QN1116); 黑龙江省自然基金青年项目(QC2011C035)

Evaluation and the advantages of hand-assisted laparoscopic surgery for colorectal carcinoma

Gui-yu WANG1,()   

  1. 1. Department of Colorectal Cancer Surery, the Second Hospital of Harbin Medical University, the Colorectal Cancer Institute of the Harbin Medical University, Harbin 10086, China
  • Received:2014-12-17 Published:2015-02-25
  • Corresponding author: Gui-yu WANG
  • About author:
    Corresponding author: WANG Gui-yu, Email:
引用本文:

王贵玉. 手辅助腹腔镜结直肠癌根治术的发展、优势与应用[J]. 中华结直肠疾病电子杂志, 2015, 04(01): 26-31.

Gui-yu WANG. Evaluation and the advantages of hand-assisted laparoscopic surgery for colorectal carcinoma[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2015, 04(01): 26-31.

手辅助腹腔镜技术是将腹腔镜微创外科技术与传统开腹手术进行最大程度结合的一个典范,近年来在结直肠癌根治术中的应用越来越普遍,并逐渐被越来越多的医生所接受。进行手辅助腹腔镜手术的步骤虽然大致与全腹腔镜相同,但是由于其恢复了术者的触觉,因此其兼顾了微创手术与开腹手术的双重优势;另外手辅助腹腔镜结直肠癌根治术还具有适应症广泛,医生学习曲线短,手术时间短,术后并发症少等优点,并且术中可以快速控制出血,对于术中出现的意外能进行最快的补救,间接提高了手术的安全性。尽管手辅助腹腔镜技术在外科治疗结直肠癌疾病中有以上诸多优势,但是也尚存在一些不足,如手在腹腔中占据空间对术者暴露视野不利,同时也可能造成气腹的严密性减低;长时间的手术造成术者疲劳等。本文旨在客观对手辅助腹腔镜外科治疗在结直肠癌的发展、优势及应用做出陈述。

In recent years, hand-assisted laparoscopic technique is the model that combines minimally invasive laparoscopic surgical techniques with traditional open surgery to the greatest extent in treatment of colorectal cancer.And this technique becomes more and more universal, and is gradually accepted by more and more surgeons.Combining the steps of the Hand-assisted laparoscopic surgery and the conventional technique of laparoscopic surgery, the result is roughly the same.However, due to that restored surgeon tactile, so it takes into account the dual advantage of minimally invasive surgery and laparotomy.Additional hand-assisted laparoscopic resection of colorectal cancer also has a wide range of indications, the shorter physician learning curve, shorter operative time, less postoperative complications, and surgery to control bleeding quickly, appearing for accident surgery could be the most quick remedy, indirectly improve the safety of surgery.Despite the hand-assisted laparoscopic technique has many advantages over the surgical treatment of colorectal cancer diseases, but there are still some shortcomings, such as hand surgery in the womb by exposure to occupy space vision unfavorable, it may also result in reducing of the rigor pneumoperitoneum; prolonged fatigue caused by surgery surgeon.This article aims to objectively summarize the development, advantage and application of assisted laparoscopic surgical treatment of colorectal cancer.

图2 手辅助腹腔镜右半结肠切除术操作孔示意图,镜孔位置在剑突下;主操作孔在左锁骨中线与左肋下缘下交点;蓝碟位置在绕脐右侧上纵切口
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