双吻合器在低位直肠癌保肛手术中的临床应用分析

Double stapling technique in the management of low rectal carcinoma

目的探讨低位直肠癌使用双吻合器在保肛手术中应用的价值。方法回顾总结分析2008年1月～2011年6月收治的85例距肛缘4～6cm的低位直肠癌患者保肛术临床资料,按TME原则,用双吻合器行低位直肠癌切除结直肠或结肠肛管吻合保肛手术。结果全组无手术死亡,术后吻合口漏1例,吻合口狭窄1例,暂时性大便不完全失禁5例,无吻合口复发、排尿困难及性功能障碍。结论在低位直肠癌保肛手术中使用双吻合器是安全有效的,可缩短手术时间,减少术中出血,保肛成功率高,显著提高患者的生活质量。

Objective To evaluate the value of double stapling technique（DST） in the treatment of low rectal anastomo- sis with the anus-preserving procedure. Methods In accordance with the principle of total mesorectal excision, from January 2008 to June 2011, we treated 85 patients with low rectal cancer by using the DST with the anus-preserving procedure. Results All of the 85 patients were treated successfully with a anus-preserving procedure rate of 100%. One of the patients developed anas- tomotic fistula after the operation. One of the patients developed anastomotic stenosis and 5 patients developed temporalitily in- completion incontinentia. There were no complications of local recurrence , dysuresia and sexual function disorder. Conclusion DST for low rectal cancer could perform anus-preserving procedure in a very low position and was minimally invasive for the treat- ment of low rectal with high rate of anus-preserving procedure rate. It shortened the operation time, reduced the bleeding and could improve the life quality of the patients.