五联术原位人工肛门整形重建的远期疗效临床研究  

A long-term effect of in situ artificial anal reconstruction using five combined operations

作　　者：张本寿[1] 储辉[1] 李增男[1] 许良标 解潮[1] 徐志久[1] 金雷[1] 袁挺[1] 林子豪[3] Zhang Benshou;Chu Hui;Li Zengnan;Xu Liangbiao;Xie Chao;Xu Zhijiu;Jin Lei;Yuan Ting;Lin Zihao(Department Surgery,100th Hospital of The Chinese People＇s Liberation Army,Suzhou 215007,China)

机构地区：[1]中国人民解放军第一00医院整形科,苏州215007 [2]苏州市工业园区九龙医院 [3]上海长征医院整形科

出　　处：《中华整形外科杂志》2018年第8期605-608,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨低位直肠癌根治术后，即时五联术原位人工肛门整形重建的远期疗效。方法60例低位直肠癌患者行Miles术后，即时五联术原位人工肛门整形重建。结果本组患者手术顺利，伤口均一期愈合，术后1周左右即有便意感，3周左右即有排便自控意识，排成形便每日1～2次。远期随访：①直肠内液体存留控制排出时间总优良率95％（57／60），显著高于单纯外括约肌重建的对照组70％（42／60）（P〈0．05）。②远期生存率，5年以上者达88％，显著高于对照组（P〈0．05）。结论低位直肠癌Miles根治术后，即同时行五联术原位肛门整形重建，既可彻底根治肿瘤，又能显著提高患者的生活质量和远期生存率，是一种安全有效的手术方法。Objective To explorea long-term effect of in situ artificial anal reconstruction using five-combined-operation technique after lower rectal cancer resection. Methods After miles operation, 60 patients suffered with lower rectal cancers underwent in situ artificial anal reconstruction using five- combined-operation technique, which included internal and external anal sphincter, rectal flap, rectal angle, and anoperineal reconstruction. Results primary healing in the wounds. Awareness of All cases in this study were performed successfully, with defecation had reoccurred in all cases since 1 week postoperatively and self-control of defecation had been regained since 3 weeks postoperatively with formed stool excreted once or twice a day. Long-term follow-ups： （1）In 95% cases, rectal controlled discharge time was longer than 2 minutes, which was significantly higher than that of sphincter reconstruction group as a control（ P 〈 0. 05 ）. （2） Five-year survival rate reached to 88% , which was significantly higher than that of the control group （ P 〈 0.05 ）. Conclusions Anal reconstruction using five-combined operation method after Miles operation could be a safe and effective surgical procedure, which could completely cure tumor, and improve patients＇ life quality and long-term survival rate.

关 键 词：低位直肠癌 肛门括约肌成形术 远期疗效 

分 类 号：R735.37[医药卫生—肿瘤]