化疗加器械吻合手术低位直肠癌保肛的研究  

Clinical study of neoadjuvant chemotherapy and assist devices on anus preserving prcedure in resection of low rectal carcinoma

作　　者：叶再元[1] 张勤[2] 谢晓红[2] 

机构地区：[1]浙江省人民医院,310014 [2]浙江省中医院,310006

出　　处：《浙江临床医学》2003年第3期170-171,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨低位直肠癌在根治条件下保肛的手术方法和体会。方法 7例低位直肠癌采用新辅助化疗后7-10d行器械辅助的直肠癌Dixon's根治术 ,观察手术操作的成功率 ,病人的恢复情况和病理报告。结果 7例病人在新辅助化疗后均按时完成Dixon'术 ,病理提示下切缘阴性 ,未出现吻合口瘘等并发症 ,术后恢复良好。结论 新辅助化疗加器械辅助治疗低位直肠癌有助于提高低位直肠癌的保肛可能性 ,是否保肛应在手术中完成肿瘤及肿瘤以下直肠的分离 ,精确测量下切缘后决定 ,吻合前彻底止血 。Objective To assess the effects of neoadjuvant chemotherapy and assist devices on anus preserving procedure in curative resection of low rectal carcinoma. Methods Seven patients with low rectal carcinoma were performed Dixon procedure with the device assist 7-10 days after neoadjuvant chemotherapy . Patients were then observed for the effects of operation. Results All patients had a successful operation after neoadjuvant chemotherapy. Pathologic examinations of the specimen revealed negative margins. No complication such as anastomotic leakage was found. All patients were well recovered. Conclusions Neoadjuvant chemotherapy plus device assist may contribute to the successful performance of anus preserving procedure in low rectal carcinoma. Whether the anus can be preserved depends on the accurate measurement of the distal length of rectum . A meticulous hemostasis and avoidance of tension on the stama are the key measures to avoid leakage.

关 键 词：低位直肠癌 保肛手术 药物疗法 器械辅助治疗 手术方法 

分 类 号：R735.37[医药卫生—肿瘤] R730.5[医药卫生—临床医学]