直肠癌Miles术会阴切口一期缝合的评价

Evaluation of the Primary Suture of the Perineal Incision in Miles' Operation of Rectal Cancer

目的 评价直肠癌Miles手术会阴切口一期缝合法在临床运用上的意义。方法 对 10 2例直肠癌Miles手术会阴切口一期缝合和敝开引流愈合的两种方法进行比较分析。结果 在年龄、性别及病理分期分级无显著差异下 ,会阴切口一期缝合组平均愈合时间为 12 0± 2 9天 ,切口敝开组为 44 1± 12 1天 ,差异显著 (P <0 0 0 1)。术后局部复发率缝合组为 3 3 9%。敝开组为 2 3 3 % ,两组无明显差异 (P >0 75 )。结论 对癌肿未累及肛直肠环的行Miles手术 ,会阴部清除范围距肛门缘外 3cm已足够。会阴切口严密止血 ,一期缝合法是可行的。

Objective To evaluate the clinical significance of the primary suture of perineal incision in Miles' operation of rectal cancer.Methods The primary suture and open drainage and healing of the perineal incision in 102 patents with rectal cancer undergone Miles' operation were analysed.Results With no significant difference in age, sex, pathological stage and grading, the mean healing time of the primary sutrue and of the open drainage of perineal incision was 12.0±2 9 days and 44.1±12 1 days respectively, significant difference was found ( P <0 01). The local recurrence rate of the primary suture and of the open drainage postoperactively was 3.39% and 2.33%, No significant difference was seen ( P >0 75).Conclusions It is enough that the resection range of the perineal region is over 3 cm from the anal edge if the anarectal ring is not involved by the cancer, the primary suture will be feasible if there is no bleeding in the perineal incision. The lipoconnective tissue in the ischiorectal fossa must be removed thoroughly for the rectal cancer, which involves anorectal ring and anal cancer.