关键词: 腹腔镜手术, 并发症, 重力线原则

Abstract:

Gravity line strategy in laparoscopic colorectal surgery：A report of 504 cases        GUAN Wen-long，CHE Zhong-guang，ZHU Yue-kun，et al. Department of General Surgery, the First Affiliated Hospital of Harbin Medical University，Harbin 150001，China
Corresponding author：ZHU An-long，E-mail：zhuanlone@163.com
Abstract    Objective    To analyze the correlation between intraoperative complications in the laparoscopic sigmoidocoli and rectal surgery and tilt view, propose a basic operating criterion for the laparoscopic procedure. Methods    The clinical data of 504 cases of laparoscopic low anterior resection and abdominoperineal resection performed between September 2006 and March 2014 in Department of General Surgery, the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively. The tilt angles（<15°, 15～30°, >30°）were measured. The incidence of intraoperative complication and tilt angle were calculated and statistical analysis was performed. Results    Tilt angles of controls group were at <15° in 437 cases， at 15～30° in 31 cases and none was at >30°. In complication group, tilt angles of surgical field were at <15° in 4 cases，at 15～30° in 25 cases and at >30° in 7 cases. The difference was significant statistically between the control group and complication group（χ2=235.57，P<0.001）. There was no statistical difference in tilt angle among the last 4 groups（100 cases in each group in chronological order）（P>0.05）. The difference was significant statistically between the 1st group and the last 4 groups（P<0.05）. Conclusion    Excessive tilt view can increase the risk of laparoscopic colorectal surgery. Gravity line strategy is proposed as one of the basic operating criteria to correct the tilt angle.

Key words: laparoscopic surgery, complication, gravity line strategy