保肛手术在低位直肠癌外科治疗的临床价值

Clinical importance of surgical treatment of low rectal carcinoma in anus preserving procedure

目的探讨低位直肠癌在根治术中保肛的方法和体会。方法86例低位直肠癌采用器械辅助的Dixon's根治术,观察成功率及患者恢复情况。结果手术成功,病理提示下切缘阴性,吻合口漏等并发症7例,术后均恢复良好。结论器械辅助治疗低位直肠癌有助于提高低位直肠癌的保肛可能性,是否保肛应在手术中完成肿瘤及肿瘤以下的分离,精确测量下切缘后决定,吻合前彻底止血,仔细处理吻合面及避免吻合口张力是减少吻合口瘘等并发症的关键。

[Objective] To access methods and experience of anus preserving procedure in curative resection of low rectal carcinoma. [Methods] 86 patients with low rectal carcinoma were performed Dixon procedure with the device assist. Patients were then observed for the effects of operation. [Result] All patients had a successful operation. Pathologic examinations of the specimen revealed negative margins. 7 complications such as anastomotic leakage were found. All patients were well recovered. [ Conclusion ] Device assistance may contribute to the successful performance of anus preserving procedure in low rectal carcinoma. Whether the anus can be preserved depends on the accurate measurement of the distal length of rectum. A meticulous hemostasis and avoidance of tension on the stama are the key measures to avoid leakage.