双吻合器48例直肠癌保肛术应用

Application of Double Stapling Device in the Sphincter Preserving Surgery in 48 Cased of Rectal Cancer

[目的]评估双吻合器在直肠癌保肛术中的实用价值。[方法]自1996年1月至1998年4月应用双吻合器进行直肠前切除端端吻合术48例，其中属低位吻合术（即吻合口位于腹膜返折平面以下者）44例，占叨．67％；其中34例系低位直肠癌（距胆缘7cm以内）。[结果]全组病倒无手术死亡；术后发生吻合口瘘2例（4．17％），吻合口狭窄6例（12．5％），与对照组相比，差异均无显著性（P＞0．05）；术后无局部复发；远处肝转移2例。[结论]双吻合器明显提高了低位直肠癌的保肛手术成功率，无局部复发，说明选为保肛手术是合适的。术后吻合口瘘和吻合口狭窄是双吻合器手术中的主要并发症。

[Purpose]To appraise the practical value of double stapling device in the Sphincer－preserving Surgery in rectal cancer [Method]Aseries of 48 cases of anterior resection with end－to－end anastomosis by double stapling device were carried out from January 1996 to April 1998 a－mong them 44 cases uderwent low anastomosis (below peritoneal reflection),and low rectal cancer (7cm or less from anal verge), were found in 34cases [Results] There was no death in operation Anastomotic leakage after double－stapling occurred in 2 cases (4.17%) and anastomotic stenosisoccurred in 6 cases (12.5%) Contrast to the control group there wasd no significant difference(p>0.05) No local recurence occurred There were2 cases of liver metastases [Conclusions]The data show that the double stapling device had significantly raised the rate of Sphincter－preservingSurgery in low rectal cancer The result indicates that double stapling device is acceptable in Sphincter－preserving Surgery Anastomotic leakage and stenosis are two common complicatons following low anostomosis with staplers.