低位直肠癌保肛术中应用双吻合器65例的临床体会

Clinical Experience of Low Rectal Cancer Surgery Anal Double Stapling of the 65 Cases

目的：探讨使用双吻合器（Double stapling technique,DST）行低位直肠癌保肛术。方法：65例患者成功使用DST技术吻合。1例手术中行I125粒子植入内放疗,5例手术中植入5-氟脲嘧啶缓释制剂化疗,其余均术后2W开始用奥沙利铂＋氟脲嘧啶＋亚叶酸钙化疗3个疗程。结果：本组65例无手术死亡及术中严重并发症,术中病理检查无残端癌;术后肛周盆腔感染1例（1.54%）,吻合口漏2例（3.08%）,吻合口出血1例（1.54%）,吻合口狭窄1例（1.54%）。手术后3个月排便功能的优良率为83.08%（54/65）。结论：选择适当病例用双吻合器行低位直肠癌保肛术是安全可行的。

Objective： Explore the use of double staplingline of low rectal cancer surgery anus. Methods： 65 cases of patients with the use of the success of DST technology fit. 1 case received I125 seed implantation surgery with radiation therapy, 5 patients implanted in 5 -- fluorouracil sustained--release chemotherapy agents, and all the rest after the beginning of 2W ＋ oxaliplatin with fluorouracil ＋ leucovorin chemotherapy 3 Course of treatment. Results：This group of 65 patients with no surgical deaths and serious complications in surgery, pathology in patients without cancer stump; perianal after 1 case of pelvic infection （1.54%）, anastomotic leakage in 2 cases （3.08%）, anastomotic bleeding 1 cases （1.54%）, anastomotic stenosis 1 （1. 54%）. 3 months after the operation of the defecation rate of 83.08 % fine （54/65）. Conclusion： Select the appropriate cases with two--line stapler lower rectal sphincter surgery is safe.