直肠癌60例手术治疗体会

Experience from surgical treatment of 60 cases of rectal cancer

目的 对直肠癌术式的选择及手术治疗过程中对膀胱和性功能的损伤两个主要的难点进行探讨.方法 回顾分析我院2005～2007年行外科手术治疗的60例直肠癌患者的病例资料,分析不同分期与不同手术方式的治疗效果.结果 直肠癌患者5年生存率Duke A、B、C期分别为97.0％,55.0％,20.0％,下段癌吻合术后发生吻合口漏1例,排尿功能障碍5例,男性勃起功能障碍6例,射精功能障碍5例.结论 中下段直肠癌保肛手术疗效确切,手术过程中应用PANP（pelvic autonomic nerve preservation）能明显降低手术对膀胱和性功能的损伤.

Objective To explore surgical options for rectal cancer and damage to the bladder and sexual functions during surgical treatment. Methods A retrospective analysis was conducted on the case files of 60 patients with rectal cancer who received surgica! treatment in our hospital from 2005 to 2007. The therapeutic effects of different surgical approaches on rectal cancer of different stages were analyzed. Results The 5-year survival rate of patients with rectal cancer in the stage of Duke A,B and C was 97.0%,55.0% and 20.0% respectively. 1 case of anastomotie leakage, 5 cases of urinary dysfunction,6 cases of erectile dysfunction and 5 cases of ejaculatory dysfunction were observed after lower rectal anastomosis. Conclusion Sphincter preservation surgery for middle-lower rectal cancer demonstrates great efficacy. Application of PANP （pelvic autonomic nerve preservation） during surgery can significantly reduce surgical damage to the bladder and sexual functions.