一层间断缝合加吻合器吻合在低位、超低位直肠癌保肛手术中的应用

Application of closing rectal stump with single layer interrupted suture and stapler anastomosis in anal sphincter reservation for low or ultralow rectal carcinoma

目的探讨一层间断缝合法关闭直肠残端加双吻合器吻合在低位、超低位直肠癌保肛手术中的的应用价值。方法回顾性分析37例低位、超低位直肠癌患者采用一层间断缝合法关闭直肠残端加吻合器吻合行保肛手术,对术后吻合口并发症、排便功能、局部复发等进行了随访。结果术后无吻合口瘘发生,无吻合口狭窄,术后排便功能控制好,无局部复发,术后10个月至2年肝脏转移3例。结论一层间断缝合法关闭直肠残端加双吻合器吻合行保肛手术具有保肛率高,操作简便,安全性高,费用低廉、术后并发症少、排便功能控制好等优点,在低位、超低位直肠癌保肛手术中的应用值得推广。

Objective To explore the practical value of closing rectal stump with single layer interrupted suture and stapler anas tomosis in the anal sphincter reservation for low or ultralow resections of rectal carcinoma. Methods Thirty-seven cases of low or ultralow rectal carcinoma with analsphincter reserved operation were reviewed retrospectively. All the patients were performed tow or ultralow resection with stapler anastomosis after closing rectal stump with single layer interrupted suture. The anastomosis complications,defecation function and regional recurranee were reviewed. Results There were no case of anastomotic leakage and no re gional recurrance in 37 patients. No anastomotic stricture was found. The defecation functions of all patients were normal. There were 3 cases of liver metastasis occured follow up 10 months to 2 years after operation. Conclusion There are high rates of the anal sphincter reservation for low or ultralow resections of rectal carcinoma with stapler anastomosis after closing rectal stump with sin gle layer interrupted suture. It is feasible,economic and convenient procedure in the anal sphincter reserved operation for low or ultralow rectal cancer . Few complications develope and anal sphincteral funtion is controlled well after operation.