中文摘要：

目的探讨电子结肠镜联合腹腔镜手术治疗复杂结肠息肉的可行性与安全性。方法回顾性分析30例基底直径≥2．0cm，位置特殊，无法内镜下摘除的结肠息肉，在电子结肠镜辅助下行腹腔镜手术治疗的近期疗效。结果30例均在双镜联合下顺利完成手术，其中肠镜辅助腹腔镜下部分肠壁切除19例，腹腔镜下肠段切除6例，双镜联合小切口辅助部分肠切除3例，术中病理证实为恶性者行腹腔镜结肠癌根治术2例。手术时间50～185min，平均（79．6±28．6）min；术后无吻合口漏和吻合口梗阻发生；有1例患者出现吻合口出血，经保守治疗痊愈。术后肠功能恢复时间1～4d，平均（2-3±2．7）d；住院时间3～12d，平均（5．0±2．0）d。术后随访6—15个月，平均（9．8±2．7）个月；除6例失随访外，24例复查肠镜未见息肉残留、复发。结论腹腔镜联合电子结肠镜不仅定位准确，对恶性患者更改切除术式灵活，而且术后并发症发生率较低，是一种治疗复杂结肠良恶性息肉安全、有效的方法。

英文摘要：

Objective To explore the feasibility and security of laparoscopic operation combined with electronic colonoscopy in treatment of complicated colonic polyps. Methods The therapeutic laparoscopy guided by electronic colonoscopy was carried out in 30 cases with the basal body diameter of the colonic polyp ≥2.0 cm and the position of the colonic polyp not suitable for endoscopic excision. Retrospective analysis was made on this material. Results Thirty cases in the laparoscopic and endoscopic jointly successfully operated, combined with the electric colonoscopy, 19 ones did the wedge excision： 6 ones did the excision of intestinal segment;3 cases received mini incision;In 2 cases, the polyp was diagnosed as malignant tumor by frozen section and then laparoscopic radical resection of colon carcinoma was carried out. Anastigmatic bleeding was found in 1, Cured by conservative treatment finally： and there were no anastigmatic stoma, obstruction, etc. The average operation time was79.6±28.6 min： the average time of intestine functional rehabilitation was 2.3±2.7 d： the average time after surgery in hospital was 5.0±2.0 d： the average time of postoperative follow up was 9.8＋2.7 months. Except 6 cases loss of follow-up, the other 24 cases which received the examination by endoscope, residue of polyp and recurrence did not occurred. Conclusions Laparoscopy combined with electronic colonoscopy accurate positioning, flexible resection patients with malignant change, and a lower incidence of postoperative complications, is a treatment for complex benign and malignant colon polyps safety and effective method.