全直肠系膜切除双器械吻合治疗低位直肠癌  

Combined Application of Double Stapling Technique and Total Mesorectal Excision for Low Positioned Rectal Cancer

作　　者：刘湘[1] 彭勃[1] 赵祥赓[1] 候开庆[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院

出　　处：《中国现代手术学杂志》2004年第6期348-350,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的　探讨双器械吻合技术联合全直肠系膜切除在低位直肠癌保肛手术中的应用和疗效。　方法　在全直肠系膜切除的基础上 ,应用双器械吻合技术 ,对 5 3例低位直肠癌行低位或超低位吻合。随访 3年 ,回顾性分析其根治性、术后排便功能、手术并发症、局部复发率。　结果　低位吻合 12例 ,超低位吻合 4 1例。无切端癌残留 ,全组无手术死亡 ,无吻合口漏。本组均随访 3年 ,6个月内每日大便次数 5～ 10次者 18例 ,余者均在 5次以下 ,6个月后所有患者大便次数均在 5次以下 ,无大便失禁。吻合口狭窄发生率 3.8% (2 / 5 3) ,肿瘤局部复发率 5 .7% (3/ 5 3)。　结论　在全直肠系膜切除基础上 ,利用双器械吻合技术行低位直肠癌保肛手术是保持排便功能 ,减少并发症 ,减少局部复发 ,提高生活质量的有效方法。Objective To investigate the specific procedure and therapeutic effect of combined application of double stapling technique(DST) and total mesorectal excision (TME) for low positioned rectal cancer. Method 53 cases of low positioned rectal cancer underwent surgery with DST for low or ultralow anastomosis, the 3-year follow-up result was retrospectively analyzed on radical resection effect, defecating function, complication rate and recurrent rate. Results Low anastomosis and ultra-low anastomotic were perfromed in 12 and 41 cases respectively. All the resection margin were clear and no occurrence of incontinence, anastomotic leakage or intraoperative death. Both anastomotic stricture rate and local recurrent rate were 3.8%(2/53) and 5.7(3/53) respectively. Conclusions Combined application of DST and TME for low positioned rectal cancer is effective in maintaining defecating function, lowering complication rate, decreasing recurrent rate and improving life quality.

关 键 词：器械吻合 全直肠系膜切除 低位直肠癌 治疗 大便失禁 保肛手术 并发症 局部复发 随访 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]