改良Bacon术在低位直肠癌保肛术中的应用

Modified Bacon Operation in Sphincter-preserving Surgery for Low Rectal Cancer

目的评价改良Bacon术在低位直肠癌保肛术中的作用。方法1998年8月～2002年12月38例低位直肠癌患者,均行改良Bacon术,术后坚持扩肛和肛门收缩锻炼。结果术后无吻合口瘘及吻合口狭窄,1例术后2 d发生多余结肠坏死。半年后病人可控制排气排便。排便次数：1～2次者16例,3～4次者20例,〉4次者2例。肛门节制功能评价：优25例,良13例。随访4.2～9.1年,1例Duke C期患者盆腔复发,死于双侧输尿管梗阻、肾衰。结论在无条件采用双吻合器手术时,改良Bacon术可以作为低位直肠癌保肛手术的一种备选术式。

Objective To evaluate the roles of the modified Bacon operation in sphincter-preserving surgery for low rectal cancer.Method The clinical data of 38 patients from August 1998 to December 2002 underwent modified Bacon operation were reviewed.All the patients were trained by anal expanding and construction everyday for 6 months.Results There was no complication such as anastomotic fistula or stenosis.But 1 patient occurred necrosis in unnecessary colon at 2 days after operation.All the patients were satisfied with continence for flatus and defecation,with the defecation frequency of 1～2 times per day in 16,3～4 times per day in 20,and more than 4 times per day in 2.The anus continence function evaluation was excellent in 25,fine in 13.During the 4.2 to 9.1 years follow-up,1 case occurred pelvic relapse,and died of bilateral uretal obstruction and renal failure.Conclusion In sphincter-preserving operation,the modified Bacon operation can be applied when double stapling technique can not achieved.