低位直肠癌保肛手术146例临床分析

Clinical analysis of anus-preserving radical resection in treatment of 146 cases with lower rectal carcinoma

目的探讨低位直肠癌的最佳治疗方法。方法对2005年7月—2010年6月间收治的低位直肠癌行保肛术的146例患者进行回顾性分析。结果术后1周内吻合口瘘11例,发生率为7.53%,6例经保守治疗后痊愈,5例二次手术行横结肠造瘘,4例手术后顺利恢复,1例急诊二次手术后出现多脏器功能衰竭、DIC而死亡。保肛手术3年内局部复发率为5.51%。结论低位直肠癌保肛手术只要把握适应证,可作为手术首选。严格掌握保肛手术指征、合理选择患者、规范手术操作是低位直肠癌保肛根治手术成功的关键。

Objective To investigate the best medical therapy in low rectal cancer.Methods Totally 146 cases of lower rectal cancer underwent low anterior resection were reviewed from July 2005 to June 2010.Results Postoperative anastomotic leakage occurred in 11（7.53%）cases within one week,6 cases were cured by conservation therapy.5 cases were performed transverse colostomy after diagnosis,4 cases were recovered after the second surgery,another one died because of postoperative multiple organ failure and DIC.Local recurrence occurred in 8 cases with the recurrence rate being 5.51% after the operation within 3 years.Conclusions If the indications were identified,the operation of preserve anal sphincter in low rectal cancer can be the first choice.Strict controling the indication of anus-preserving operation,a reasonable choice of patients and standard operation were key to successful radical operation in low rectal cancer.