拖出式双吻合器直肠切除术治疗低位直肠癌疗效观察

The pull-through combined with double stapling technique for the lower rectal carcinoma

目的评价低位直肠癌保留肛门括约肌功能的最佳治疗术。方法2000年11月至2006年2月对42例低位直肠癌采用直肠拖出,双吻合器技术行保肛的手术切除。结果全组无手术死亡,术后发生吻合口瘘2例,吻合口狭窄5例,术后平均随访30个月,4例手术后18个月局部癌复发（9.5%）,余38例无癌生存,全组术后平均8～12周排便次数及功能接近正常人。结论拖出式双吻合器直肠切除术在确保癌根治的情况下,保存了肛提肌和肛管内、外括约肌,保存了正常排便功能。

Objective：To evaluate a novel operative modality with sphincter preservation in the treatmert of low rectal carcinoma.Methods： The Resection through pull-through combined with double stapcing technique for sphincter preservation approach was performed on 42 patients with low rectal carcinoma from December 2000 to January 2005.Results： There was no death in operation.Only two got anastomosis leak and five got anastomotic stenosis after operation.The mean follow-up period was 30 months.Local recurrence was found in four cases（9.5%）18 months after the operation,and 38 cases were cancer free till the end of the follow-up.Defecation was satisfactorily controlled 8～12 weeks after the operation.Conclusion： Pull-through combined with double stapling technique can meet the criterion of the redical resection of rectal carcinoma,and keep the internal and external sphincter muscles intact in the lower anterior resection.The normal defecationcan can maintain after the operation due to the preseration of internal and external sphincter muscles.