双吻合器吻合法在直肠癌保肛手术中的应用

Double stapling technique for anus saving in low rectal cancer

目的评估双吻合器吻合法在直肠癌保肛手术应用中的安全性和实用性。方法回顾总结４年中采用该技术行直肠癌手术９７例。癌灶下缘距肛缘平均距离８２ｃｍ，其中３～７ｃｍ４２例（４３３％，４２／９７），大于８ｃｍ５５例（５６７％，５５／９７）。结果所有患者吻合器切除圈完整。术后吻合口漏９例（９３％，９／９７），肿瘤距肛缘小于７ｃｍ患者的吻合口漏发生率显著高于距离大于７ｃｍ的患者（Ｐ＜０．０５），神经性膀胱排空障碍５例（５２％，５／９７），切口感染７例（７２％，７／９７），吻合口出血４例（４１％，４／９７），术后肛门部疼痛１例（１０％，１／９７）。结论双吻合器吻合法可作为低位直肠癌保肛手术的一种安全可靠的术式选择。

Objective To evaluate the safety and feasibility of double stapling technique (DST) in anus saving operations for patients with low rectal carcinoma.Methods From May 1994 to today, this technique was used in ninety seven patients with low rectal cancer. The average distance between the anal verge and the lower margin of the tumor was 8 2 cm(4～15 cm).Results Nine patients had anastomotic leakage (9 3%, 9/97) postoperatively and all healed with or without diverting colostomy. Five patients suffered from neurogenic bladder postoperatively (5 2%, 5/97). Wound infection occurred in 7 patients (7 2%, 7/97), anastomotic bleeding in 4 (4 1%, 4/97) and anal pain in 1 (1 0%, 1/97), respectively.Conclusions These results suggest that DST provided a safe alternative for anus saving operation in patients with rectal cancer.