男性低位直肠癌患者腹腔镜下全直肠系膜切除联合直肠经肛门拖出式吻合术的治疗体会  

Treatment for Male Patients with Low Rectal Cancer by Means of Laparoscopic Total Mesorectal Excision and Per Anum Rectal Pull-Type of Anastomosis

作　　者：刘红波[1] 杨安[1] 冯运章[1] 张贵堂[1] 刘奇[1] 

机构地区：[1]河北省邯郸市中心医院普外二科,邯郸056002

出　　处：《中国普外基础与临床杂志》2010年第11期1179-1182,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨男性低位直肠癌患者行腹腔镜下全直肠系膜切除联合直肠经肛门拖出式吻合术的治疗效果。方法回顾性总结23例男性低位直肠癌患者保肛手术成功的经验。结果本组病例行腹腔镜全直肠系膜切除术,充分游离直肠下端并离断肿瘤近端后,将远端直肠和肿瘤一并经肛门拖出,闭合器切闭肿瘤远端,管状吻合器行直肠与降结肠端端吻合。23例患者均成功保留肛门,无手术死亡。术中及术后病理检查残端无肿瘤残留,术后均未发生吻合口漏。结论针对骨盆相对狭窄的男性患者,利用腹腔镜行全直肠系膜切除联合直肠经肛门拖出式吻合术,对于低位直肠癌保留肛门是安全可靠的,它可以简化手术难度,提高低位直肠癌保肛手术的成功率。Objective To study the effect of laparoscopic total mesorectal excision and per anum rectal pull-type of anastomosis on male patients with low rectal cancer.Methods The successful experiences of anus saving operation on 23male patients with low rectal cancer were summarized.Results A laparoscopic total mesorectal excision technique was used,with the full separation of the rectum at the bottom.After pulling out the distal rectum together with the cancer from the anus,the transection of the proximal tumor was performed.The end-to-end anastomosis of rectum and descending colon was performed by tubular stapler.Anus was reserved successfully in the 23cases.There was no left-tumor stump after surgery detected by postoperative pathological examinations,no anastomotic leakage,and no operative death.Conclusions To the relatively narrow male pelvis,laparoscopic total mesorectal excision and per anum rectal pull-through resection and anastomosis is safe and reliable for anus saving in low rectal cancer.It can simplify the operation,and raise the success rate of sphincter preserving in surgery of low rectal cancer.

关 键 词：低位直肠癌 腹腔镜 全直肠系膜 拖出式切除 吻合器 

分 类 号：R735.3[医药卫生—肿瘤]