常見的大腸直腸手術

  1. 手術考慮因素
    1. 病患因素
      1. 性別
      2. 年齡
      3. 肥胖
      4. 過去病史
    2. 腫瘤因素
      1. 淋巴轉移
      2. 分化及Distal or lateral margin: Well/ Moderate/ Poor
      3. 種類: Ulcerative, Polypoid, Scirrhous
      4. 大小及數目
      5. 息肉: 單一或多發性
      6. 位置: 肛口距離﹐相關器官﹐括約肌
      7. 局部侵犯 遠端轉移
      8. 併發症 阻塞﹐破裂﹐腹膜炎
  2. 手術方法
    1. Abdominal Perineal Resection(APR)
    2. Lower/ (High) Anterior Resection / EEADouble-staple or Pull-through
    3. (Extended) Left hemicolectomy / mesenteric tunnel
    4. (Extended) Right hemicolectomy
    5. Subtotal colectomy / ileostomy
    6. Total colectomy / J-pouch ileoanal anastomosis
    7. Posterior / Total Pelvic Exenteration
    8. Hartmann’s procedure
    9. Segmental resection
    10. Local Treatment
      1. Transrectal Excision (TRE)
      2. Electrocoagulation
      3. Laser therapy
    11. Bypass Operation
      1. Ileocecal bypass
      2. Ileotransversostomy
      3. Ileosigmoid colon anastomosis
    12. Diversion procedure
      1. Sigmoid colostomy (Loop or End)
      2. Distal/ Proximal Transverse colostomy (Loop or End)