盆脏切除Ⅰ期原位肛门重建术

THE RECONSTRUCTION SURGERY OF PRIMITIVE ANUS IN STAGE I OF THE EXCISION OF THE PELVIC VISCERA

目的:报道DukesCD期直肠癌,扩大根治,盆腔脏器切除术后,原位肛门、阴道重建。方法:6例CD期(T_3N_3M_0)直肠癌,行直肠、子宫及附件(或膀胱、前列腺)阴道、肛门切除,原位肛门阴道重建。结果:随访1至5年,排便功能优5例,便秘1例,性功能恢复5例。1年内死亡1例,3年死亡2例,5年死亡2例。结论:直肠癌邻近脏器浸润,无明显远处转移而拒绝Miles术及单纯腹壁造瘘者,行盆腔脏器切除,原位肛门重建,可提高生存期内的生活质量。

ve: To reporton expanding; radical cure, reconstruction of primitive anus and vagina in Dukes C. D stage of rectal carcinoma after the excision of pelvic viscera. Methods: For a group of 6 cases of C. D stage (T4N3M0) rectal carcinoma, resection of rectum, uterus and annex uteri (or urinary bladder, prostate gland), vagina and anus, reconstruction of primitive anus and vagina, formation of external glutaeus maximus sphincter and construction of artificial vagina in the ileum of pedicle were carried out. Results: 1-5 years follow-ups show excellent defecation function for 5 cases, constipation for 1, sexual recovery for 5, death within-one-year 1 case, with-in-three-year 2, within-five-year 2. Conclusions: In the case of rectal carcinoma with infiltration of nearby viscus and without remarkable for distance metastasis, who refused Miles Surgery and pure abdominal fistulization, do the surgery of excision of pelvic viscera and reconstruction of primitive anus, the quality of his life can be improved and his life prolonged