经肛荷包单吻合器技术在高难度低位直肠癌保肛手术中的应用

Application of Transanal Purse-string Single Anastomosis in the Saving-anus Procedure by Stapler for Low Rectal Carcinoma with Great Difficulty

为探讨经肛荷包单吻合器技术在高难度低位直肠癌前切除保肛手术中的优越性，选择因肥胖、骨盆狭窄、远端闭合困难或器械吻合失败的距肛门7cm以下的超低位直肠癌患者121例，在严格遵循TME原则的前提下，采用经肛荷包单吻合器技术行保肛手术治疗。结果显示，121例患者全部完成保肛手术，2例（1．65％）术后2周内发生吻合口漏，3例（2．47％）发生吻合口狭窄，3例（2．47％）局部复发，无手术死亡。结果表明，采用经肛荷包单吻合器技术对高难度低位直肠癌行直肠癌前切除保肛手术疗效满意，方法简单、安全，值得临床推广。

For the objective of explore the advantages of the procedure（transanal purse-string single anas- tomosis） in the treatment of low rectal carcinoma with great difficulty,authors selected 121 cases with super-low rectal carcinoma（≤7cm far from anus）, who had corpulency, narrow pelvis, distal closure difficul- ty, or failure from apparatus anastomosis, as subjects to be subjected to above-procedure under the principle of TME strictly. As results,in the patients the procedure was all performed completely; among them in 2 cases（1. 65%） occured anastomotic leakage, in 3 cases（2.47%） occured anastomotic stenosis,in 3 cases （2.47%） occured local recurrence, but no operative death was found. Results show that above-mentioned procedure in the treatment of low-rectal carcinoma with great-difficulty has satisfactory outcome and simple and safe manipulation,thus it is worth to populate.