单吻合器与双吻合器技术在直肠癌低位前切除术中的临床应用分析  

Analysis of clinical application of single stapling and double stapling technique in low anterior resection for rectal cancer

作　　者：周活动 

机构地区：[1]阳江市人民医院普外科,广东阳江529500

出　　处：《结直肠肛门外科》2010年第4期214-216,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的评价单吻合器与双吻合器技术在直肠癌低位前切除术中临床应用的效果。方法对2003年1月至2010年1月68例低位前切除加单吻合器技术及57例低位前切除加双吻合器技术患者的临床资料作分析比较。结果两组所有患者保肛手术均获成功,无手术死亡,术后病理远端切缘未见癌残留。两组手术时间、术中出血量、住院时间均无统计学意义(P>0.05)。吻合口漏,双吻合器组1例(1.7%),单吻合器组3例(4.4%),两组间比较差异无统计学意义(P=0.74)。住院费用,双吻合器组为2.45万元(2.1～3.2万元),单吻合器组为1.9万元(1.7～2.2万元),两组间差异有统计学意义(P<0.05)。结论单吻合器与双吻合器技术均可完成直肠癌低位超低位吻合术,具有保肛成功率高,手术时间短,并发症少等优点,安全可行。而单吻合器较双吻合器更为经济实用,适合在基层医院开展。Objective To evaluate the clinical results of the single stapling and double stapling technique in low anterior resection for rectal cancer. Methods Clinical data of 68 cases of low anterior resection with single-stapling technique and 57 cases of low anterior resection with double stapling technique from January 2003 to January 2010 was comparative analyzed. Results All rectal surgery were successful,no mortality,and no pathologic distal margin of residual cancer. There was no significant difference between the two groups in mean operating time,blood loss,and hospital stay （P〈0.05）. Anastomotic leakage was happened once in double stapling group （1.7%）,and third in single stapler group （4.4%）,and there is no statistical difference （P=0.74）. Hospitalization costs was 2.45 million double in stapling group （2.1～3.2 million）,and it was 1.9 million in single stapling group （1.7～2.2 million）. The difference between the two groups was significant （P〈0.05）. Conclusion The single stapling and double stapling technique can complete ultra low anastomosis for rectal cancer. The sphincter preservation success rate is high,and operative time is short,and with few complications,and they are safe and feasible. But the single stapling is more economical and practical than double stapling,and the single stapling is good for local hospitals.

关 键 词：吻合器 直肠癌距肛缘距离 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]