低位直肠癌经腹会阴切除一期肛门原位再造术

Transabdominal Perineum Resection and Primary Reconstruction of Ano in Situ in the Treatment of Low Rectal Carcinoma

探讨低位直肠癌经腹会阴切除、一期肛门原位再造术的临床效果，对该术式治疗62例下段直肠癌进行回顾性分析。62例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，8～17次／d，无便意，口服止泻药，排便次数正常，术后28周养成定时排便习惯，大便成形。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，局部复发率1．7％（1／58），3年生存率88．5％（46／52），5年生存率83．3％（30／36）。结果表明，低位直肠癌经腹会阴切除、一期肛门原位再造术是一种安全、可靠有效的治疗直肠癌术式。

In order to analized the therapeutic effect of transabdominal perineum resection and primary reconstruction of ano in situ in the treatment of low rectal carcinoma,the clinical data of 62 such cases were analized retrospectively. As results, no ischemic necrosis, stricture and retraction occurred in all the 62 cases;postoperative defecation was 8-17 times/day in the early stage and there was no defecation sensation, which became normal after oral administration of antidiarrheal;and timed defecation and normal shape of stool became possible later 28 weeks after the operation. The follow-up rate was 93.5 % （58/62） ,averaging 4 years. Local recurrence rate was 1.7 % （1/58）, 3-year survival rate was 88.5 % （46/52）, and 5-year surviv- al rate was 83.3 % （30/36）. It is suggested that transabdominal perineum resection and primary reconstruction of ano in situ is a safe,reliable ＆ effective surgical procedure in the treatment of low rectal carcinoma.