低位直肠癌游离自体肠平滑肌片内括约肌重建术的临床研究

Anal Internal Sphincter Reconstruction with Free Autograft of colonic Smooth Muscle for Low Rectal Cancer

目的:观察低位直肠癌自体肠平滑肌内括约肌重建的功能结果。方法:从1996年10月～1998年12月,31例低位直肠癌患者行自体平滑肌内括约肌重建术,在齿线处行结肛吻合,均没有行预防性结肠或回肠造口,肿瘤距肛缘的距离为4～7cm。结果:术后仅1例吻合口复发,无远处转移,住院期间无患者死亡,术后三个月肛门括约功能明显恢复。优良率达82.1％。结论:本术式在充分根治的基础上,符合肛门排便的三个基本功能:括约、感觉和储存功能,在低位直肠癌的治疗中,是一种较为合理的手术方式。

Objective:To study the functional outcome of internal sphincter reconstruction with free autograft of colonic smooth muscle for low rectal cancer. Methods: Between 1996.10and 1998. 12,31patierts with low rectal cancer were performed coloanal anastomosis at the dentate line and internal sphincter reconstruction with free autograft of colonic smooth muscle . None of them had preventive stoma. The distance of the tumor from the anal verge was 4-7cm. Results: Only one patients had anastomotic recurrence and no distance metastasis, no patient died during hospitalization. 29 percent of the patients had complications. Anal function recovered significantly 3 months after operation. Satisfactory fecal continence was achieved in 82.1 percert of the patients. Conclusions:On the basis of radical treatmemt, the method accords with three physiologic function of anal defection:continence, sensation and reservior and it is a rational operation methods for low rectal cancer.