腹腔镜部分或次全内括约肌切除术治疗超低位直肠癌的疗效

Efficacy of laparoscopic partial or subtotal intersphincteric resection for ultra-low rectal cancer

目的 探讨腹腔镜部分或次全内括约肌切除术治疗超低位直肠癌的疗效。方法 回顾性分析14例行腹腔镜部分或次全内括约肌切除术治疗超低位直肠癌患者的临床资料。结果 14例患者均无围手术期死亡。1例术后1周出现吻合口部分裂开,1例术后12d出现吻合口瘘,均经保守治疗痊愈。随访6～54个月,1例局部复发。所有患者术后6个月肛门功能Kirwan分级为1或2级,1例患者出现吻合口狭窄,需要定期扩展。结论 腹腔镜部分或次全内括约肌切除术治疗超低位直肠癌安全可行。

Objective To investigate the efficacy of laparoscopic partial or subtotal intersphincteric resection for ultra-low rectal cancer. Methods Clinical data of 14 patients with ultra-low rectal cancer underwent laparoscopic partial or subtotal intersphincteric resection were retrospectively analyzed. Results No postoperative death occurred. One patient got partial anastomotic crack in a week and another patient got postoperative anastomotic fistula on the 12th day after operation, both of whom were managed through conservative treatments. During 6 to 54 months of follow up, local recurrence took place in one case. In 6 months after operation, the anal functions of all patients turned out to be in Kirwan class 1 or 2 and one patient got anastomotic stenosis, which required regular expansion. Conclusion Laparoscopic partial or subtotal intersphincteric resection for ultra-low rectal cancer is safe and feasible.