中低位直肠癌保肛拖出术34例

Pull-out Operations for Preserve Anus in 34 Cases with Middle or Low Located Rectal Carcinoma

目的：探讨中低位直肠癌保肛拖出术的适应证。方法：分析34例中低位直肠癌保肛拖出术。结果：3年生存率为88．1％，5年生存率为60％。根据大便控制能力及是否带会阴布垫将其分四级，Ⅰ级10例，Ⅱ级22例．Ⅳ级2例于2年后作腹壁人工肛门。结论：中低位直肠癌保肛手术应慎重，下切缘不得少于3cm。青年人（＜30岁者）直肠癌保肛手术更应慎之又慎。粘液腺癌及低分化腺癌，有淋巴结转移者不宜行保肛术。

Purpose: To study the indications about the pull-out operation for preserve anus in middle or low located rectal carcinoma. Methods: A retrospective analysis was carried out in 34 cases who underwent pull-out operation. Results: It was found that the survival rates in 3 and 5 years were 88. 1% and 60% respectively. According to the stool control ability with or without cloth rill, 4 grades were divided. There were 10 cases in grade Ⅰand 22 cases in grade Ⅱ Abdominal artifical anus was made for 2 cases of grade Ⅳ after 2 years. Conclusions: The preserve anus operation should be caution, especially for young people(less than 30 years old) and the inferior margin should not be less than 3cm. The preserve anus operation is contraindicated for those mucous adenocarcinoma or low -differential cancer, or with lymph node metastasis.