直肠全系膜切除并直肠癌保肛手术

THE RADICAL RECTECTOMY WITH TOTAL MESORECTAL EX-CISION AND ANAL PRESERVED IN MID-LOW RECTAL CANCER

目的：探讨中低位直肠癌根治术中直肠系膜全切除后保留肛门的可行性、保肛术的适应证及维持术后肛门功能的可能性．方法：回顾性总结了１９９３年至１９９９年保留肛门的中低位直肠癌根治术１２４例，讨论保肛手术的可行性和术后直肠感觉及肛门功能恢复的可能行，提出保肛手术的适应证。结果：９７．５％（１２１／１２４）的病人下切缘无癌浸润，术后２年内局部复发率为４.８％（６／１２４）。９２.７％（１１５／１２４）的病人恢复顺利，术后直肠感觉及肛门功能恢复较满意。结论：保肛手术能提高术后生活质量，只要掌握好手术适应证及做到根治性切除，效果是好的。

Objective: To explore the possibility of preserving anal after total mesorectal excision in radical rectectomy of mid-low rectal cancer and maintaining its function and to discuss the indi- cation of this procedure according to our experience. Methods: We retropectively summurized 124 cases of mid-low rectal cancer which were radical operated with preserving anal from Oct. 1993 to Oct. 1999, discussed the possibility of anus-preserving and recovering rectal sensation and func- tion of anus, put forwad the operating indication. Results: 97.5% of patients have not had cancer in the margine, the rate of local recurrence is 4.8% in two years. 92.7% of patients recovered and have good function in retal-anal. Conclusion: Radical rectectomy with anal preserved can im- prove postoperative quality of life and have good effects if it is used properly.