经内外括约肌间切除术治疗超低位直肠癌23例分析

Treatment of intersphincteric resection for ultra low rectal tumor:an analysis of 23 cases

目的探讨经内外括约肌间切除术(intersphincteric resection,ISR)治疗超低位直肠癌的应用价值。方法2005年3月至2007年3月四川省人民医院普外三科对23例病灶下缘距离齿状线≤2cm的超低位直肠癌进行术前评估,行ISR,其中5例进展期直肠癌术前行新辅助化疗。结果全组无手术死亡,平均随访24个月,均未发现局部复发,1例出现远处肝转移,所有病人术后6个月至1年肛门功能恢复满意。结论ISR是一种可选择的治疗超低位直肠癌的根治性保肛方法。

Objective To explore the effect of intersphincteric resection （ISR） as the sphincter-saving procedure for ultra low rectal tumor. Methods From March 2005 to March 2007, 23 ultra low rectal tumor patients whose distal tumor edges were no more than 2em from the dentate line were evaluated preoperatively. All of them were underwent ISR. Five patients with advanced rectal cancer received preoperative chemo-radiation. Results There was no pefioperative death. The average time of follow-up was 24 months. Twenty-three patients showed no evidence of local recurrence. They were satisfied with their fecal control after 6 months. Conclusion ISR is an alternative sphincter-saving procedure for the radical resection of ultra low rectal tumor.