全直肠系膜切除并单吻合器在低位直肠癌根治术中的应用

Total mesorectal excision and single stapling technique in low positioned rectal cancer

目的探讨全直肠系膜切除联合单吻合器在低位直肠癌中的应用效果。方法在全直肠系膜切除(TME)基础上,对56例低位直肠癌应用单管状吻合器与荷包钳做保肛手术。随访2年,回顾性分析其根治性、术后排便功能、手术并发症、局部复发率。结果全组无手术死亡,术后病理学检查无切端癌残留,无大便失禁,无吻合口漏发生,吻合口狭窄2例,发生率4%(2/56),术后随访2年,局部复发3例,复发率为5%(3/56),患者术后肛门功能恢复较满意。结论全直肠系膜切除应用单吻合器与荷包钳用于低位直肠癌可提高保肛率,且该方法经济、实用、安全。

Objective To evaluate the effect of total mesoreetal excision with single, stapling technique for low positioned rectal cancer. Methods Based on total mesorectal excision, 56 cases of low ：positioned rectal cancer underwent anal preserving operation with single stapling technique and purse-string forceps. The 2 years follow-up result was retrospectively analyzed on radical resection effect, defecating function, complication rate and recurrent rate.. Results All the resection margins were clear and had no intraoperative death,anastomotic leakage or occurrence of incontinence. Anastomotic stricture rate was 4 % （2/56） and local recurrent rate was 5 % （3/56）. The patients were satisfied with anal function. Conclusion Based on total mesorectal excision,anal ：preserving operation for low positioned rectal cancers using single stapling technique and purse-string forceps can improve the postoperative quality of life,that is safe, feasible, practical and economical.