全直肠系膜切除术结合双吻合器在低位直肠癌手术中的应用

Application of TME Combined with Dual Stapler Technique in Low Rectal Cancer Surgery

目的探讨全直肠系膜切除术(total mesorectal excision,TME)结合双吻合器(DST)治疗低位直肠癌的效果及临床价值。方法对我院60例低位直肠癌患者采用TME和DST联合治疗的方法,观察治疗后的排便功能及疗效。结果所有患者手术均顺利,无吻合口瘘和狭窄,切割环均完整,无手术闭合失败及手术死亡。随访时间6个月～5年,局部复发率为3.33%。排便控制功能:优55例(91.7%),良5例(8.3%),差0例。排便感觉功能:优43例(71.7%),良17例(28.3%),差0例。结论TME和DST联用可为低位直肠癌保肛手术的首选术式。疗效满意,并发症少,提高了患者的生存质量,值得临床推广。

Objective To explore the effect and clinical value of TME combined with dual stapler technique （DST） in treatment of low rectal cancer. Methods Sixty patients with low rectal cancer underwent TME combined with DST in our hospital, and the bowel function and efficacy were observed after treatment. Results All patients passed a smooth anes- thesia and successful operation, no anastomotic fistula and narrow occurred, cutting central was completed, and no surgical failure and death happened. Follow - up for 6 months to 5 years, the local recurrence rate was 3.33 %. The defecation control function showed 55 cases giftecl （91.7%）, 5 cases good （8.3 % ）, and 0 case poor. The defecation sensory function showed 43 cases gifted （71.7%）, 17 cases good （28.3 % ）, and 0 case poor. Conclusions TME combined with DST should be considered as the first choice in treatment of low- rectal cancer, with satisfactory outcome and less complications; it improves the patient＇s life quality and is worthy of promotion in clinic.