自体平滑肌移植节制性结肠造口的康复效果

The Contienent Colostomy with autograft of smooth muscle

目的：直肠癌Miles术后用自体平滑肌移植以建造节制性结肠造口。方法：1981－06～1997－06，82例直肠癌行自体平滑肌移植节制性结肠造口；用Schmidt手术，取一段正常的乙状结肠去除系膜脂肪和粘膜，行节制性腹壁结肠造口。结果：粪便节制率78．1％（64／82），患者不需要长时间使用造口用具；3例移植物感染，坏死后去除；无手术死亡率；无功能丧失。结论：该方法术后功能良好，并发症很少；推荐使用自体平滑肌括约肌成形用于直肠癌节制性结肠造口，康复效果良好。

Autograft of smooth muscle was used for abdominal wall comtinent colostony in Miles operation of the rectal cancer. Methods: Continent colostomy was performed in 82 cases from June 1981 to June 1997 with autograft of smooth muscle. In sphincteroplasty, a normal segment of colon, 10cm in length, freed from mesenteric fat and mucosa were taken to make a continent colostomy on abdominal wall with Schmidt opera tion. Results: The patients achieved continence in 78. 1% (64/82) . Stool bags were no longer necessary after operation. Removal of the graft was necessary only in 3 of 82 cases due to the necrosis. The surgical mortality rate was zero. No disfunction in continence of the sphincter were seen. Conclusions: Postoperative function was favorable and complication low.Autograft of smooth muscle was therefore recommended in colostomy of rectalcancer.