经腹肛门切除一期肛门原位再造治疗低位直肠癌

Anterior resection with anorectal reconstruction for low rectal cancer

目的探讨低位直肠癌经腹、肛门切除，一期肛门原位再造的临床效果和实用性。方法对62例下段直肠癌行经腹肛门切除，一期肛门原位再造术的病例进行回顾和总结。结果62例病人中未发生再造肛门缺血坏死和狭窄、回缩。术后早期排便次数多，常在8～17次／d，无便意，口服止泻药、排便次数正常。术后28周养成定时排大便习惯，大便成形。病人有58例获得随访（随访率93．5％，58／62），平均随访4．0年，其中局部复发1例（1／58局部复发率17％）。3年生存数46例（生存率88．5％，46／52），5年生存数30例（生存率83.3％，30／36）。结论低位直肠癌经腹肛门切除、一期肛门原位再造是一种安全、可靠有效的直肠癌术式。

AIM To investigate the therapeutic efficacy and feasibility of anterior resection with anorectal reconstruction for low rectal cancer. METHOD Sixty - two patients with low rectal cancer received anterior resection with anorectal reconstruction and were followed up for as long as 5 years. RUSULTS No postoperative complications like anal stenosis, retraction and ischemia were recorded,but normal defecation reflex and bowel habit did not restored until averaged 28 weeks later. Three-year survival rate was 88.5% （46/52）. and five - year survival rate was 83.3% （30/36）. CONCLUSION Anterior resection with anorectal reconstruction has very high efficacy, reliability and accessibility.