结肠套式拖出肛管吻合术治疗低位直肠癌48例

Intussusception Pull-through of Colon and Anastomosis with Anus Treatment of Low Rectal Carcinoma： Analysis of ~8 Cases

为探讨结肠套式拖出肛管吻合术治疗低位直肠癌的治疗效果，回顾分析48例低位直肠癌应用结肠套式拖出肛管吻合术的临床效果。肿瘤切除后使直肠远端外翻，近端结肠经外翻的直肠拖出，于肛门外行结直肠一期吻合，并立即送回盆腔。随访3～10年，随访率100％。肛门功能正常及良好46例，较差2例。无大便失禁者。术后发生吻合13漏1例，术后吻合口狭窄1例，局部复发率16％。5年生存率65％，10年生存率38％。结果表明，只要严格掌握手术适应症，应用保留肛门括约肌的结肠套式拖出肛管吻合术治疗低位直肠癌，可获得较高的生存率及生活质量。

The therapeutic efficacy of the intussusception pull-through of colon and anastomosis with anus in the treatment of low rectal carcinoma was assessed in the rectrospective study, and the the clinical results of 48 cases were analised. The procedure included： （1） eversion of the distal rectum after tumor removal （2）pulling the proximal colon through the everted rectum （3）primary colon-rectum anastomosis at out anus and instantly pushing it back into the pelvic cavity. All the 48 cases were followed up for 3-10 years. As results,anal function was found normal and fairly good in 46 cases,no fecal incontinence was found, there was postoperative anastomotic leakage in one case,anastomotic stricture in one case,local recurrence rate was 16%. 5-year survival rate was 65% and 10-year survival rate was 38G. It is concluded that the procedure of intussusception pull-through of colon and anastomosis with anus in the treatment of low rectal carcinoma can ensure a higher survival rate and better life quality so iong as the surgical indication is strictly followed.