全系膜切除术和双吻合技术在直肠癌保肛手术中的应用

The application of total mesorectal excision with double stapling technigue in anal sphincter preservation operation for patients with rectal cancer.

目的评价全系膜切除术(Total mesorectal excision,TME)联合双吻合技术在直肠癌保肛手术中的近期治疗效果。方法回顾性分析我科2004年2月~2005年12月经TME联合保肛手术的病例,共41例。结果41例保肛手术中,肿瘤离肛缘8.2cm(4cm^12cm),其中,4~5cm者5例。术中出血350ml(100~800ml)。术后并发吻合口漏2例,腹腔出血2例。结论TME联合双吻合技术是提高保肛技术成功率的有效方法,规范化的应用该一技术可降低术后近期并发症。

Objective To evaluate the safety and feasibility of double stapling technique combined with TME on anal sphincter preservation operations in patients with rectal cancer. Methods Between Feb 2004 to Dec 2005, 41 cases of sphincter preservation operations were included and retrospectively analysised. Results The medium distance from the lesion to anal verge was 8.2 era, including 4 - 5era from the anal verge in 5 cases. Intraoperative blood loss was 350 ml, ranged from 100ml to 800ml. Anastomotic leakage occurred in 2 cases, bleeding in two cases, one patient needed colostomy. Conclusions Double stapling technique combined with TME facilitate sphincter- preservation operations are effective in patients with lower rectal cancer. Postoperative complications can be minimized by standardizing the techniques.