直肠拖出和双吻合器超低位直肠癌保肛术的应用与观察  

Application of rectum pull-out and double stapling technique used in sphincter preservation surgery for the treatment of super-low rectal carcinoma

作　　者：赵晓光[1] 闫飞虎[1,2] 王为民[3] 付红兵[3] 查玮[3] 卞承玲[2] 

机构地区：[1]解放军第四一三医院普通外科,浙江舟山316000 [2]第二军医大学附属长海医院 [3]第二军医大学附属长征医院

出　　处：《海军医学杂志》2013年第6期365-367,共3页Journal of Navy Medicine

摘　　要：目的评价应用直肠拖出和双吻合器技术实施超低位直肠癌保肛手术的疗效。方法2004年10月至2010年10月利用直肠拖出和双吻合器保肛技术，对19例超低位直肠癌患者行癌肿切除术。肿瘤下缘距肛缘4～7cm，平均5．5cm。Dukes分期：A期11例，B期7例，C期1例。结果19例均成功地保留了肛门和大便控制功能。术后发生1例（5．3％）吻合口狭窄。全部患者平均随访20个月，其中有2例（10．5％）局部复发，死亡1例（5．3％），18例存活至今；无发生排尿功能障碍者；83．3％的男性患者和71，4％女性患者术后性功能良好。结论直肠拖出和双吻合器保肛术是安全可行的，为超低位直肠癌患者提供了新的保肛术式选择。Objective To evaluate the effect of pull-out and double stapling technique used in sphincter preservation surgery for the treatment of super-low rectal carcinoma. Methods Tumor excision was performed in 19 patients with super-low rectal carcinoma with the pull-out and double stapling technique for sphincter preservation from Oct, 2004 to Oct, 2010. The distance from the low edge of the tumor to the anal edge was 4-7 cm（5.5 cm on average）. Of the 19 patients, 11 were in Dukes A stage, 7 were in Dukes B and 1 was in Dukes C. Results Anus and fecal continence were preserved successfully in all the patients. Stricture of anus occurred only in 1 case （5.3 % ）following surgery. Twenty-month follow-ups indicated that 2 patients had local recurrence （10.5 % ）and one patient died （5.3%） and 18 patients survived. There was no urinary dysfunction in this series. There was no case of urinary dysfunction after sur gery. The male （83.3 % ） and female （71.4% ） patients still had good sexual function after surgery. Conclusion The pull-out and double stapling technique used for sphincter preservation surgery was feasible and safe, and it provided a new option for sphincter pres ervation surgery in patients with super-low rectal carcinoma.

关 键 词：直肠肿瘤 直肠拖出 外科缝合器 保肛手术 

分 类 号：R47[医药卫生—护理学]