直肠癌术后原位肛门重建术的临床研究

Clinical Research for in situ Reconstruction of Anus after the Surgery for Rectal Carcinoma

为探讨Miles术后改进内外括约肌在原位肛门重建的方法和效果，对60例低位直肠癌患者行Miles根治术后，同时行改进的内外括约肌原位肛门重建术，改进包括：1）肛门内括约肌改进为双层双环肌套；2）肛门外括约肌改进为外括约肌浅部和深部的重建。结果显示，60例低位直肠癌术后重建后的肛门外形及远期生活质量和生存率均更为满意，总优良率为95％，远期生存率为80％。结果表明，低位直肠癌Miles术后，同时行改进的内外括约肌原位肛门重建的效果是可行的，更接近正常的肛门解剖结构和生理功能。

In order to explore the method and effect of the modified internal-external sphincter in situ re- construction of anus after Miles procedure,the 60 patients with low rectal carcinoma who had been subjeet to Miles procedure received author＇s modified internal-external sphincter in situ reconstruction of anus.Its modified main points include. 1）internal sphincter was modified as double-layer double-ring muscular ve- lum;2）external sphincter as its deep part and shallow part reconstruction.As results, the 60 patients were more satisfied for the appearance of reconstructed anus, long-term quality of life, and survival rate, total fine rate was 95% ,long-term survival rate was 80%.Results show that after Miles procedure for low rectal carcinoma just immediately performing above modified reconstruction of anus is feasible,its efficacy is sat- isfactory,closer to normal anatomic structure and Dhvsiological function of anus.