支撑吻合管在低位直肠癌保肛术中的应用研究  

Application of anastomotic support tube or anus-saving operation for low rectal cancer

作　　者：李月春[1] 王东霞[1] 叶镇彭[1] 韩晓光[1] 胡夏荣[1] 王彤[1] 王在国[1] 韩方海[2] 伍晓汀[2] 

机构地区：[1]广东省东莞市人民医院肿瘤外科,523018 [2]四川大学华西医院普外三科

出　　处：《结直肠肛门外科》2008年第4期238-240,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨支撑吻合管在低位直肠癌全直肠系膜切除(TME)基础上行结肠-直肠/肛管吻合的应用。方法155例低位直肠癌TME术后,应用支撑吻合管经肛门行结肠-直肠/肛管吻合进行消化道重建。结果本组155例无手术死亡及术中严重并发症,术中病理检查无残端癌;术后肛周盆腔感染2例(1.29%),吻合口漏3例(1.94%),吻合口出血5例(3.23%),吻合口狭窄4例(2.58%)。寿命表法计算5年生存率和局部复发率分别为78.06%(121/155)及6.45%(10/155)。手术后3个月排便功能的优良率为82.58%。结论低位直肠癌TME术后应用支撑吻合管行结肠-直肠/肛管吻合是安全可行的。Objective To evaluate a surgical procedure of colo-rectal （anal） anastomoses with anastomotic support tube after total mesorectal excision （ TME） for lower rectal cancer. Methods A total of 155 patients with lower rectal cancer underwent alimentary tract reconstruction by colo-rectal （anal） anastomoses with a anastomotic support tube after TME. Results There was no perioperative mortality. All the resection margins were clear. Infection of cavitas pelvis in 2 （ 1.29 % ）, anastomotic leakage developed in 3 cases（1. 94%）, anastomotic hemorrhage in 5 （3.23%）, and stenosis in 4 （2.58%） after operation. Postoperative 5-year survival and recurrence rate was 78.06 % （ 121/155）, 6.45% （10/155） respectively. The defecation function was satisfactory in 82. 58% cases. Conclusion Colo-rectal （anal） anastomoses with anastomotic support tube after TME is safe and elective for lower rectal cancer.

关 键 词：直肠肿瘤 保肛手术 重建 支撑吻合管 

分 类 号：R735.37[医药卫生—肿瘤]