凯途在低位直肠癌保肛术应用32例体会

Clinical study of 32 cases of radical excision with anus preservation by Contour stapler in low and middle rectal cancer

目的探讨应用凯途通过双吻合器法保肛术治疗低位直肠癌的安全性及临床疗效。方法回顾性分析32例低位直肠癌经腹行根治性切除术,术中应用凯途通过双吻合器法进行保肛术。结果手术时间为150~210 min。术后发生吻合口漏2例（6.3%）,吻合口狭窄1例（3.1%）,无吻合口出血;术后4~12周时排便功能基本恢复到正常。随访期内术后局部复发率为3.1%（1/32）,无肝转移,无死亡病例。结论凯途双吻合器法保肛术能在极低位完成保肛术式,可以缩短手术时间,减少术中出血量,较直线型吻合器使用更方便,同时可以保留良好的肛门排便功能,显著提高了患者的术后生活质量。

Objective To study the curative effect and safety of Contour stapler in double stapling technique {DST） to treat low rectal cancer with anus-preserving procedure. Methods A retrospective analysis was carried out in 32 eases of low rectal cancer performed with Contour stapler in double stapling technique with anus-preserving procedure. Results The mean operation time is 150-210 rain. Postoperative complications were observed, 2（6.3%）cases of anastomotic leak, 1 （3. 1%）cases of anastomotic stenosis, and no anastomotic bleeding. All patients recovered normal defecating function during 4-12 weeks in post operation. Local recurrence was 3.1% （1/32）, and there were no hepatic metastasis and no death cases in follow-up phase. Conclusion DST with Contour for low rectal cancer can perform anus-preserving procedure in a very low position. It shortens the operation time, reduces the bleeding, and is more convenient than linear type staple. With the procedure, the anal function can be preserved well, and the quality of life is raised markedly. With the low local recurrence and hepatic metastasis, it deserves generalization.