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目的探讨内镜与腹腔镜(双镜)联合治疗结直肠良恶性息肉的应用价值。方法尝试运用多种双镜联合的方式治疗结直肠良恶性息肉,比较其临床效果。结果46例双镜联合治疗患者,其中腹腔镜辅助内镜下治疗5例(10.87%),内镜定位腹腔镜切除30例(65.22%),内镜腹腔镜同步切除6例(13.04%),追加腹腔镜根治术5例。46例中息肉恶变21例(45.7%),其中浸润性癌6例,3例淋巴结转移。内镜协助腹腔镜手术41例无中转开腹,术后吻合口漏2例,吻合口出血1例。腹腔镜保护内镜治疗的5例无并发症发生。双镜联合患者随访时间1～21个月,息肉恶变者术后无一例复发。结论双镜联合增加了内镜治疗的安全性和适应证范围,减少了手术创伤,是结直肠良恶性息肉治疗的合理方法。
Objective To investigate the value of endoscopic and laparoscopic (double mirror) combined treatment of benign and malignant colorectal polyps. Methods Try to use a variety of dual mirror combination of benign and malignant colorectal polyps, the clinical effect. Results Among the 46 cases treated with double mirror combined therapy, 5 cases (10.87%) were assisted by endoscopic laparoscopy, 30 (65.22%) cases were endoscopic laparoscopic resection, 6 cases (13.04%) were treated by endoscopic laparoscopy, Additional laparoscopic radical mastectomy in 5 cases. Among the 46 cases, 21 cases (45.7%) had malignant transformation of polyps, including 6 cases of invasive carcinoma and 3 cases of lymph node metastasis. Endoscopic assisted laparoscopic surgery in 41 cases without transit laparotomy, anastomotic leakage in 2 cases, anastomotic bleeding in 1 case. Laparoscopic protection of endoscopic treatment of 5 cases without complications. Patients were followed up for 1-21 months with two mirrors. None of the polyposis patients had recurrence after operation. Conclusion Double mirror combined with endoscopic therapy to increase the safety and scope of indications and reduce the surgical trauma, is a reasonable method of treatment of benign and malignant colorectal polyps.