保留外括约肌原位肛门重建术治疗低位直肠癌的研究  

Study of anal reconstruction in situ preserving sphincter ani externus for low rectal carcinoma

作　　者：谭东新[1] 

机构地区：[1]广西壮族自治区人民医院一分院

出　　处：《中国临床新医学》2009年第6期604-607,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨保留外括约肌原位人工肛门重建术治疗低位直肠癌的疗效。方法对比23例保留外括约肌原位肛门重建（肛重建组）与31例腹会阴联合切除（Miles组）的低位直肠癌的治疗效果；比较两组患者术后5年生存率、局部复发率和控便能力。结果肛重建组和Miles组术后局部复发率分别为26．1％和25．8％，5年生存率分别为60．5％和59．3％，两组差异无统计学意义（P〉0．05）；肛重建组控便能力逐渐好转，12个月后已无患者有大便失禁，而Miles组术后丧失控便能力，大便次数明显多于肛重建组，两组差异有统计学意义（P〈0．05）。结论低位直肠癌行保留外括约肌原位肛门重建术可获得满意的肿瘤根治效果，同时患者能保留肛门括约功能，具有良好的控便能力。Objective To explore the curative effects of anal reconstruction in situ preserving sphincter ani extemus for low rectal carcinoma. Methods Twenty - three patients underwent anal reconstruction in situ preserving sphincter ani extemus（ ASRP group ） was compared with 31 patients underwent Miles operation （ Miles group ）. Analysis was conducted on local recurrence rate, 5 - year survival rate, and fecal control function between the two groups. Results The local recurrence rate of ASRP group and Miles group was 26. 1% and 25.8% respectively, the 5 -year survival rate of the two groups was 60. 5% and 59.3% respectively, and there was no significant difference between the two groups （ P 〉 0. 05 ）. The fecal control function of patients in ASRP group improved gradually and after 12 months there was no patients occuring fecal incontinence. But the patients of Miles group had not fecal control function and their times of defecation was more than that of ASRP group. The patients of ASRP group had better post- operative fecal control function than Miles group （ P 〈 0. 05 ）. Conclusion Anal reconstruction in situ preserving sphincter ani extemus for low rectal carcinoma has advantage treatment effects and achieves good fecal control function.

关 键 词：低位直肠癌 原位肛门重建 

分 类 号：R735.3[医药卫生—肿瘤]