双吻合器在低位直肠癌保肛术中的应用

Double stapling technique in anus-saving operation for lower rectal cancer

目的 评估双吻合器在低位直肠癌保肛术中的作用。方法 回顾性分析采用双吻合器在96例低位直肠癌保肛术中应用的临床资料。结果 男 63例 ,女 33例 ,年龄 2 2～ 84(平均 5 7.7)岁。肿瘤下缘距齿状线的距离为 4～ 7cm。A期 2 4例 ,B期 30例 ,C期 30例 ,D期 12例。组织学分型 :高分化型腺癌 47例 ,中分化型腺癌 2 7例 ,低分化型腺癌 17例 ,粘液腺癌 5例。无没有手术死亡 ,术后发生吻合口漏 12例 (12 .5 % ) ,均经治疗后痊愈 ,吻合口狭窄 5例 (5 .2 % ) ;经扩肛处理后治愈。结论 双吻合器在低位直肠癌保肛术中的应用是一种可靠的方法 。

Objective To determine the role of double stapling technique(DST) in anus-saving operations for lower rectal cancer. Methods The clinical data of 96 patients with lower rectal carcinoma treated by DST were analyzed retrospectively. Results There were 63 males and 33 females,aged from 22 to 84 (an average of 57.7 yesars). The distance from the lower end to dens line was 4～7cm.Dukes classfication: 24 patients belonged to A class, 30 B class, 30 C class,and 12 D class. Histological type: 47patients had high differentiation adenocarcinoma, 27 median differentiation adenocarcinoma, 17 low differentiation adenocarcinoma,and 5 mucous adenocarcinoma. No one died after the operation but 12 had anastomotic leakage(12.5%)postoperatively and all healed after treatment; 5 patients had anastomotic constriction(5.2%)postoperatively and all healed with expanding anus. Conclusions DST is a safe alternation for anus-saving operation for patients with rectal cancer.Conservative therapy is effective in the treatment of anastomotic constriction and anastomotic leakage.