国产一次性双吻合器在中低位直肠癌保肛手术中的应用  

Application of domestic disposable double stapling device in sphincter-preserving operation for mid/low rectal cancer

作　　者：廖健南[1] 邱磊[1] 谢沛标[1] 周爱华[1] 钟育波[1] 

机构地区：[1]南方医科大学附属佛山医院(广东省佛山市第二人民医院)普外三科,广东佛山528000

出　　处：《中国普通外科杂志》2012年第4期399-402,共4页China Journal of General Surgery

摘　　要：目的:探讨国产一次性双吻合器在中低位直肠癌保肛手术中应用的安全性和实用性。方法:回顾性分析2005年5月—2010年12月采用国产一次性双吻合器对63例中低位直肠癌患者行保肛手术的临床资料。结果:全组男40例,女23例;平均年龄为64.5±1.7(34～85)岁。肿瘤下缘距肛缘距离中位值为6.0(4.0～10.0)cm;肿瘤最大直径中位值为4.0(1.3～11.0)cm。TNM分期为:I期9例(14.3%),II期17例(27.0%),III期28例(44.4%),IV期9例(14.3%)。全组63例全部一次吻合成功,吻合圈完整,无吻合不全或漏钉情况。术后6例发生并发症(吻合口瘘2例,吻合口狭窄,切口感染,肺部感染,胃瘫各1例),无围术期死亡病例。共随访52例(82.5%),术后中位随访时间为32(7～67)个月,其中13例因肿瘤远处转移死亡,3,5年生存率分别为82.7%和62.3%。结论:国产一次性双吻合器应用于中低位直肠癌保肛手术是安全可行的。Objective： To evaluate the safety and utility of domestic disposable double stapling device in anus-preserving operation for mid/low rectal cancer. Methods： The clinical data of 63 patients with mid/low rectal cancer undergoing anus-preserving operation from May 2005 to December 2010 by using domestic disposable double stapling device were retrospectively analyzed. Results： Of the patients, 40 were male and 23 were female. The average age was 64.5±1.7 （34-85） years, the median distance between the tumor lower edge and anal verge was 6.0 （4.0-10.0） cm and the median tumor size was 4.0 （1.3-11.0） cm. The TNM stages were stage I （9 cases, 14.3%）, stage II （17 cases, 27.0%）, stage III （28 cases, 44.4%） and stage IV （9 cases, 14.3%）. All the 63 patients underwent a single anastomosis without reinforcement. All staple lines were intact and complete without breakdown. Complications occurred in 6 cases after surgery （2 cases of anastomotic leakage, 1 case each of anastomotic stricture, wound infection, pneumonitis and gastric retention, respectively） and there was no perioperative death. Fifty-two patients （82.5%） were followed up with a median period of 32 （7-67） months, during which time, 13 cases died from distant metastases.The 3- and S-year survival rate was 82.7% and 62.3%, respectively. Conclusion： Domestic disposable double stapling device is safe and feasible for sphincter-preserving operation of mid/low rectal cancer.

关 键 词：直肠肿瘤/外科学 吻合术 外科 一次性设备 

分 类 号：R735.3[医药卫生—肿瘤]