拖出切除附加末端回肠造瘘在腹腔镜低位直肠癌保肛手术中的治疗分析

The Advantage of Laparoscopic Total Mesorectal Excision and The Clinical Value of Pull-through Resection with Anastomosis and Preserving Anus in The Treatment of Low Rectal Cancer

目的:探讨拖出切除及回肠造瘘在腹腔镜低位直肠癌根治保肛术中的应用效果。方法:回顾2009年6～10月对10例肿瘤下缘距齿线<5 cm的低位直肠癌腹腔镜根治术,拖出切除及回肠造瘘的临床资料。结果:本组无死亡病例,平均住院时间13 d,无肠瘘,无梗阻发生,无肛门失禁。结论:拖出切除及回肠造瘘在低位直肠癌根治保肛术中,可以达到直肠癌根治和低位保肛的目的且效果良好。

Objective：To evaluate the advantage of laparoscopic total mesorectal excision（TME） and the clinical value of pull-through resection with anastomosis and preserving anus in the treatment of low rectal cancer.Method：To retrospective analyse the clinical data of 10 patients with rectal cancer which the inferior margin of the tumor from the dentate line 5cm from Jun 2009 to Oct 2009.All the patients were carried out laparoscopic TME combined with pull-through anastomosis.Result：In all of the 10 patients,TME and the pull-through anastomosis were completed under a laparoscope.The mean operation time was 220 minutes（range from 180 to 300）.There was no death,no fistula,no obstruction and no anal incontinence in the group.Conclusion：laparoscopic TME combined with pull-through anastomosis making sure that total mesorectal rectal excised and lymph node in pelvis were removed completely,is essential to achieve a radical operation of low rectal cancer and preserved anus.