直肠癌45例手术治疗临床分析  

Clinical analysis of 45 surgical operations in rectum cancer

作　　者：童宗培 周其林[1] 

机构地区：[1]安徽省滁州市中西医结合医院外二科,239000

出　　处：《白求恩军医学院学报》2010年第1期11-13,共3页Journal of Bethune Military Medical College

摘　　要：目的探讨直肠癌手术治疗的效果。方法回顾性分析45例行直肠癌切除术患者资料,26例行经腹直肠癌切除术(Dixon),其中吻合器吻合18例,手工吻合8例;18例行腹会阴联合直肠癌根治术(Miles);1例行经腹直肠癌切除、近端造口、远端封闭手术(Hartmann手术)。结果45例患者均治愈出院。Dixon组中无吻合口狭窄、出血,其中手工吻合组中出现吻合口漏1例;Miles组中会阴切口感染3例,腹部切口感染1例,造瘘口无并发症。全部病例随访1～3年,局部复发8例,吻合口复发3例;术后发生肝转移2例;腹腔内广泛转移8例。随访中,1年内死亡1例,2年内死亡2例,3年内死亡2例。结论掌握直肠癌手术治疗的适应证,选择合适的手术方式,做好并发症的预防和处理,是直肠癌手术成功的关键。Objective To investigate the clinical effect of rectal cancer surgical treatment. Methods The clinical data of 45 cases of rectal cancer were retrospectively analyzed. In those cases ,26 received Dixon operations, 18 received Miles operations and one received Hartmann operation. In 26 Dixon operations, 18 patients were sutured with anastomat ,while the other 8 patients were sutured by hand. Results All patients were cured. There was no stenosis or bleeding of anastomotic stomata in Dixon operations. One stomal leak happened in one operation where manual anastomosis was used. In Miles operations, infection of perineums incision occurred in 3 cases and infection of abdomen incision took place in one case. There was no complication of orificium fistulae. All cases were followed up for 1 year to 3 years. 8 cases suffered from partis recurrence and 3 cases suffered from stoma recurrence. 2 cases took hepatic metastasis and 8 cases abdominal cavity metastasis. One patient died one year after operation. Two patients died 2 years after operation and another 2 died 3 years after operation. Conclusion The key to success of rectal cancer operation was to grasp operation indication of rectal cancer, choose right ways of operation and prevent complications.

关 键 词：直肠癌 手术治疗 并发症 

分 类 号：R735.37[医药卫生—肿瘤]