ABSTRACT
Objective To investigate the safety and therapeutic effect of modified laparoscopic Dixon surgery for mid-low rectal carcinoma. Methods From September 2004 to April 2007,26 patients with mid-low rectal carcinoma were selected to receive modified laparoscopic Dixon surgery.Through the anus,the rectum was pulled out,the tumor was removed,and then colon-rectum anastomosis was performed.Results All the operation was completed successfully.The average operation time was(166.3 ? 48.1) min,and the mean blood loss was(235.4 ? 124.7) ml.No patient had urethral injury,dysuria,anastomotic leakage,or other complications after the operation.The patients expelled gas(2.9?0.7) days after the operation.Their mean hospital stay was(8.8?1.4) days.During a follow-up of 15.7 months(6 to 27 months),3 patients had local recurrence,5 patients showed increased frequency of stool,and 18 had satisfied anal function.Conclusion The short-term results indicate that the modified laparoscopic Dixon surgery is safe and effective for mid-low rectal carcinoma,and is associated with minimal invasion.
ABSTRACT
Objective To evaluate the feasibility and effectiveness of laparoscopic-assisted modified Swenson’s operation for Hirschsprung’s disease in infants. Methods A total of 13 infants with Hirschsprung’s disease including 11 males and 2 females were treated by laparoscopic-assisted modified Swenson’s surgery. Three- or four-trocar technique was used under a CO2 pressure of 8-10 mm Hg. The seromuscular layer of the colon was obtained for pathological examination. The mesenteries of the sigmoid colon and rectum were dissected by Ligasure, and the rectum was dissected down to 0.5-1.0 cm above the dentate line. Through the anus, the angusty and transmigration segment of the intestinal canal were evaginated, pulled out, and resected. Whole-layer colon-rectum anastomosis was performed,?21 mm stapler was used in 3 cases. Results All the operations were completed with laparoscopy in 85-161 min (mean, 115 min). The blood loss was less than 12 ml in all the patients. No intraoperative complications occurred. After the operation, 3 patients developed intestinal inflammation, 1 had anastomotic leakage, and 1 feces stain. All the compilations were cured by conservative treatments. The patients were followed up for 6 to 42 months (mean, 26 months), during which no one had complications. Conclusion Laparoscopic-assisted modified Swenson’s operation is feasible and effective for Hirschsprung’s disease in infants.
ABSTRACT
Objective To explore the safety and feasibility of laparoscope-assisted radical gastrectomy for gastric cancer.Methods Fifty-four cases of gastric cancer were selected to carry out laparoscope-assisted radical gastrectomy,including 12 radical total gastrectomies,18 proximal gastrectomies,and 24 distal gastrectomies.Lymphonodes were dissected by D1 in 29 cases and D2 in 25 cases.Results All of the 54 operations were performed successfully.The average operative time was(164.4?38.7)min in total gastrectomies,(142.4?35.2)min in proximal gastrectomies,and(149.1?35.4)min in distal gastrectomies.The mean volume of bleeding was(164.6?80.1)mL in total gastrectomies,(149.5?94.7)mL in proximal gastrectomies,and(152.5?87.7)mL in distal gastrectomies.The average number of lymphonodes dissected was 19.1?6.5 per case.After operation,the mean time of passage of gas via anus was(3.7? 0.7)d,and the mean length of hospital stay was(9.2?1.7)d.Two cases experienced postoperative anastomotic bleeding,and was controlled by conservative treatment.No other complications,such as anastomotic leakage,anastomotic obstruction,or duodenal stump leakage were experienced.Conclusions This results reveal that laparoscope-assisted radical gastrectomy is safe and feasible for gastric cancer.As long as the principles of cancer surgery are strictly followed,it can maintain radical tumor removal and exhibit the character of minimal invasion.