双吻合器在低位直肠癌手术中的地位(附113例分析)

The role of double stapling device in surgical treatment in low rectal cancer.

1993年1月至1995年4月应用双吻合器进行直肠前切除端端吻合术(Dixon术)113例,其中属低位吻合术(即吻合口位于腹膜返折平面以下者)88例,占77.88%;内81例系低位直肠癌(距肛缘7cm以内),占同期116例低位直肠癌的69.83%。全组无手术死亡;术后发生吻合口漏5例(占4.4%),吻合口狭窄12例(占10.6%);术后局部复发5例,其中2例为吻合口复发,3例为盆腔复发,总的局部复发率4.4%。本组资料显示双吻合器明显提高了低位直肠癌时的保肛手术成功率,局部复发未见增加,说明选作保肛手术是合适的。术后吻合口漏和吻合口狭窄是双吻合器手术中的主要并发症,本文讨论了并发症的防治问题。

A series of 113 cases of anterior resection with end-to-end anastomosis by using double stapling device were carried out during January 1993 through April 1995,among which 88 cases were low anastomosis (bolow peritoneal reflection) and 81 cases were low rectal cancer (7cm or less fromm anal verge)accounted for 69.83% of all low rectal cancer in this period. There was no operative death. Anastomotic stricture occurred in 12 cases (10.6%). There were 5 cases of local recurrence including of 2 in anastomosis and 3 in pelvis with an overall local recurrence rate of 4.4%. The data have showed that the double stapling device has significantly raised the sphincter saving resection rate in low rectal cancer without increasing the local recurrence rate simultaneously. Anastomotic leakage and stricture are two common complications following low anastomosis with staplers.