弧形切割吻合器在低位直肠癌超低位前切除术中的应用

目的总结弧形切割吻合器在低位直肠癌超低位前切除术中的应用价值。方法2005年12月至2006年9月选择56例低位直肠癌患者在全直肠系膜切除和侧方淋巴结清扫的基础上,应用弧形切割吻合器对直肠(肛管)残端进行切割、闭合,用33mm管型吻合器进行超低位结肠-直肠(肛管)吻合术。结果56例低位直肠癌患者术中没有发生切割和闭合不全的病例,吻合口无渗漏。手术后住院时间为(11.2±3.2)d,无死亡者。发生吻合口瘘2例(3.6%),经过局部引流而自然愈合1例,因直肠阴道瘘进行横结肠造口转流1例,无吻合口狭窄。结论弧形切割吻合器在低位直肠癌超低位前切除术中具有切割完整、闭合确实、吻合口瘘发生率低的优点,有良好的应用推广价值。

Effect of curved cutter stapler in the ultra low anterior resection for low rectal cancer

OBJECTIVE: To evaluate the curative effect of curved cutter stapler (Contour, Ethicon Endo-Surgery, Inc) in the ultra low anterior resection for low rectal cancer. METHODS: Clinic data of 56 patients with low rectal cancer from Dec. 2005 to Sep. 2006 were reviewed retrospectively. After total mesorectal excision (TME) and lateral lymph node dissection (LLD) in 56 cases, the rectal (anal) remnant was cut and closed with curved cutter stapler (Contour), and preserved for ultra low colo-rectal (anal) anastomoses with 33 mm straight intraluminal stapler. RESULTS: There was no operational death and the mean hospitalization time was (11.2+/-3.2) days. The incidence rate of postoperative complications in 1 month was 3.57% (2/65). Both of the cases were anastomotic leakage. One was cured by surgical drainage, the other combining with rectal vaginal fistula was cured by transverse colostomy. CONCLUSION: Curved cutter stapler has the advantages of complete cutting, safe closure and low anastomotic leakage rate in the process of ultra low anterior resection for low rectal cancer.