全直肠系膜切除术治疗直肠癌48例临床分析

Clinical Analyses the Treatment Efficacy of Total Mesorectal Excision in 48 Patients

目的:回顾性分析行全直肠系膜切除术(total mesorectal excision , TME)治疗直肠癌疗效.方法:2001年6月至2006年6月,对48例直肠癌病人行TME技术治疗,其中37例利用双吻合器行直肠癌切除保肛术,11例采用TME处理盆腔后类似Miles行永久性造口术.结果:全组病人无手术死亡.术后吻合口漏4例,吻合口狭窄1例,吻合口出血1例,排便习惯改变13例,会阴切口感染2例.本组病例随访3～60个月,性功能障碍1例,局部复发3例,吻合口复发1例,肝转移4例,死亡2例.结论:直肠癌术中TME可明显降低直肠癌术后局部复发率及提高直肠癌切除保肛率,减少性功能障碍发生,但也给病人带来一些不利的因素.

Objective:Retrospectively analyses the treatment efficacy of total mesorectal excision,TME,in rectal cancers cases.Methods:From Jun.2001 to Jun.2006,48 rectal cancers cases were treated with TME.In which,37 cases with rectal cancer resection with double intestinal stapler,11 cases with Miles permanent colostomy after TME.Result: No patient dead post-TME surgery.But there are anastomotic fistula in 4 cases,anastomotic stenosis in 1 case,anastomotic bleeding in 1 case,bowel habits change in 13 cases,perineum wound infection in 2 cases.In the 3～60 months follow-up,sexual dysfunction in 1 case,local recurrence in 3 cases,anastomotic recurrence in 1 case,liver metastases in 4 cases,death 2 cases.Conclusion:TME greatly lower the local recurrence rate of rectal cancers cases post-surgery,and increases the rate of remaining archos of rectal cancer resection,lower sexual dysfunction.But the patients will endure some negative outcomes.