全直肠系膜切除联合单吻合器在中低位直肠癌保肛手术中的应用

Application of total mesorectal excision combined single stapler in rectal cancer with preservation of mid-low rectal carcinoma

目的探讨全直肠系膜切除(total mesorectal excision,TME)+吻合器技术在中低位直癌手术的应用效果。方法对85例中低位直肠癌患者实施TME原则的根治性手术,应用弯管消化道吻合器行低位结肠-直肠端端吻合术。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85例均完整切除直肠系膜,无手术死亡,手术后发生吻合口瘘2例(2.3%),吻合口狭窄3例(3.5%),经定期扩肛后缓解;术后患者肛门括约肌功能良好。结论TME术式基础上应用弯管消化道吻合器行结肠-直肠低位吻合符合直肠肛门生理要求,具有操作简单安全,吻合成功率高等优点,值得推广。

Objective： To evaluate the value of totalmesorectal excision（TME） and low colorectostomyformid-low rectal carcinoma by applying themechanical anastomosis.Methods： Radical excision of mid-lowrectal carcinomawas performed on 85 patients according to TME principle,and low colorectal end-to-end an-astomosiswas performed by the tubiform digestive-tract staplers.Those data were retrospectively reviewed in light of radical results,postoperative bowel movement,surgical complications and rate of local recurrence.Results： The mesorectum of 85 patients was cut completely and no one died in operation.Two cases（2.3%） of postoperative anastomotic leakage and 3 cases（3.5%）of anastomotic stenosic occurred in all the 85 cases,which was relieved by periodically anus expanding.The functions of anal sphinter recovered smoothly afteroperation.Conclusion： It is worthy to be popularized for the advantages of convenient handling,safety,high anastomosis success rate of themechanical anastomosis after tumor resection according toTME principle.