直肠下段癌腹会阴切除并会阴部肛门再造术

Abdomen-perineum Resection and Anus Reconstruction at perineum for Rectal Low-segment Carcinoma

为了给直肠下段癌患者探求一种避免腹部永久性肠造口的手术方法，我们对113例患者行手术治疗，腹部手术操作同Miles术，会阴部手术在齿状线下方切口，保留部分外括约肌，将结肠与肛门吻合。结果显示，本组患者5年生存率达61．1％（69／113），术后排便功能良好占62．8％（71／113），手术并发症占14．2％（16／113）。结果表明，对于没有条件施行超低位前切除或经肛门局部切除的直肠下段癌患者，或因某种原因拒绝腹部肠造口的患者，可选用腹会阴切除并会阴部肛门再造术。

In order to search for a procedure to avoid permanent ostomy at patient＇s abdomen,authors performed on the 113 cases following procedure：abdomen manipulation was same as Miles procedure, perineum procedure included taking incision below dental line,saving a part of external sphincter,anastomosing colon and anus. As results, among the 113 cases 5-year survival rate was up to 61.1% （69/113）, 71 cases （62.8%） had better postoperative defecation function, 16 cases（14. 2%） occured complication. Results show that for the patients with rectal low-segment carcinoma who are unable to be subjected to super-low anterior resection or to local resection,or who refuse to receive intestinal ostomy at their abdomen due to certain reason it may be to select abdomen-perineum resection and anus reconstruction at perineum.