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  3. 微創右結腸全腸系膜及D3淋巴結廓清手術 傷口小恢復快完整切除

微創右結腸全腸系膜及D3淋巴結廓清手術 傷口小恢復快完整切除

2020/1/2
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五十多歲A 姓病患罹患大腸癌,求診中國醫藥大學新竹附設醫院大腸直腸外科主任沈名吟,沈名吟以「微創右結腸全腸系膜及D3淋巴結廓清」手術,經過2小時,成功完整切除右結腸惡性腫瘤。A 姓患者當天就下床,術後隔天就開始正常飲食,手術後第四天已出院,恢復良好。這次微創右結腸手術,中醫大新竹附醫也透過視訊,邀集全國約40位大腸直腸專長的醫師一起觀摩,互相交流。

 

沈名吟指出,一般腹腔鏡大腸癌切除手術,因手術難度較高、手術風險較大,若無法做到「右結腸全腸系膜及D3淋巴結廓清手術」,恐導致病患的腫瘤復發機率提高,因此配合院慶活動安排手術與視訊觀摩,示範、分享手術技巧與概念。

 

「微創右結腸全腸系膜及D3淋巴結廓清」手術,重點第一是肚子只有兩到三個大約只有1公分的傷口及下腹一個取出標本的小傷口,可以讓病患的術後疼痛降低,減少腹壁傷害;第二是所有手術切除及腸道重建、吻合都在腹腔內進行,讓正常組織傷害受損機率降低、加快手術術後恢復速度;最重要的第三點,是使用3D腹腔鏡新式器械,完整切除右結腸全腸系膜,清除上腸系膜動靜脈淋巴結,將所有可能轉移侵犯的淋巴組織清除乾淨,達到最徹底完整的手術,增加大腸癌病患的治癒率。

 

微創手術病人術後恢復進食較快、手術傷口較小且疼痛度較低、通常在術後第一天就可以下床,住院四至五天即可出院。微創右結腸全腸系膜及D3淋巴結廓清手術更優於一般腹腔鏡微創手術,治癒率更高。

 

在陳自諒院長及沈名吟主任率領下,大腸直腸外科以微創手術為主,中國醫藥大學新竹附設醫院自民國107年12月開院至今一年多,共執行214台3D腹腔鏡微創手術,第四期肝轉移的腫瘤切除手術也可以進行微創,微創手術比例高達97%,肛門保留機率(保肛率)高達96.4%,讓患者在治療成效、術後恢復以及照護服務得到優質的效果。

 

大腸直腸癌的初期症狀並不明顯,故容易疏忽或遺漏。如果排便出血、貧血、腹痛、食慾不振、體重減輕、糞便形狀變細等症狀,一定要立刻就醫。建議每年要做糞便潛血反應、每三年大腸鏡檢查等。同時,每天至少運動30分鐘,健康飲食多吃高纖蔬果、少吃紅肉及加工肉品,不要抽菸等,就可遠離大腸直腸癌。

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