32例保留肛门外括约肌低位直肠癌保肛术的临床分析

Clinical Analysis of Preserving External Sphincter of Anus for 32 Cases of Anus Preservation Operation on Low Position Rectal Cancer

目的：探讨保留肛门外括约肌低位直肠癌保肛手术的应用。方法：在全直肠系膜切除的基础上,应用国产一次性管状吻合器,对32例低位直肠癌行保留肛门外括约肌超低位结肛吻合,随访12-36个月。回顾性分析其根治性、术后排便功能、手术并发症、局部复发率。结果：全组病例术后病理检查无切端癌残留,无大便失禁,无吻合口漏;全组无手术死亡;肿瘤局部复发率9.4%（3/32）。结论：低位直肠癌保留肛门外括约肌保肛手术,遵循肿瘤根治的原则下,能保留患者正常的肛门排便功能,明显改善该类患者的生活质量。

Objective：To discuss the application about preserving external sphincter of anus in anus preservation operation on low position rectal cancer.Methods：Basing on total mesorectal excision,we preserved external sphincter of anus and inosculated colon and anus by throw-away anastomat in 32 cases of low position rectal cancer.All patients were followed up 12 to 36 monthes.The radical cure,the function of defecation after operation,complication and local recurrence were retrospectively analyzed.Results：There were no tumor residue in cutting terminal tissue by pathology, intraoperative death, postoperative scatacratia and the stoma leak. Local recurrence rate was 9.4% （3/32）. Conclusion.. Using anus preservation operation of preserving external sphincter of anus on low position rectal cancer,we can maintain function of defecation and improve the living quality of patients remarkably based on radical principle of tumours.