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首页> 美国卫生研究院文献>International Surgery >Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach
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Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

机译：单切口加一孔腹腔镜全直肠系膜切除术和双侧盆腔淋巴结清扫术治疗晚期直肠癌—内侧脐带韧带方法

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We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.
机译：我们通过内侧脐带入路方法对直肠癌行单切口加一孔腹腔镜（SILS + 1）腹腔镜全直肠系膜切除术（TME）+盆腔外侧淋巴结清扫术（LPLD）的安全性和可行性。关于单切口多端口腹腔镜低位前路切除术与LPLD的报道很少。最近，已经报道了微创手术，如单切口加1端口（SILS + 1）用于晚期直肠癌，是安全可行的。据我们所知，这是首次报道的用于LPLD的SILS + 1病例。将伤口保护器插入30毫米的经脐切口。接下来，将单端口访问设备安装到伤口保护器上，并放置3个端口（每个5毫米）。在右下象限中插入了一个12毫米端口。直肠和双侧LPLD超低位前切除术以及临时回肠造口术采用SILS + 1进行，失血量为50 mL，总手术时间为525分钟。右侧解剖时间为74分钟；左侧解剖的时间为118分钟。解剖的淋巴结总数为57个，解剖的外侧淋巴结总数为21个（左侧盆腔淋巴结8个，右侧盆腔淋巴结13个）。没有观察到术后吻合口功能不全或排尿功能障碍。我们已经通过内侧脐带方法证明了SILS + 1-TME + LPLD的安全性和可行性。

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