经肛门括约肌间切除管扎式结肠肛管吻合术治疗超低位直肠癌

目的评价经肛门括约肌间切除管扎式结肠肛管吻合术治疗超低位直肠癌的安全性和临床效果。方法回顾性分析2004-10～2009-12共21例超低位直肠癌经肛门括约肌间切除管扎式结肠肛管吻合术的临床资料。结果 21例手术全部成功,无手术死亡,无吻合口漏发生。随访时间为6～68个月,平均32个月;2例手术后直肠癌局部复发,其中1例病死;2例手术后肛门狭窄,再次手术扩肛;术后12个月肛门括约肌功能达优良者14例。结论肛门括约肌间切除(ISR)保肛手术治疗超低位直肠癌是安全可行的,可以达到在根治前提下保留肛门的目的 。

Application of sustaining -tube ligation procedure for colo -anal anastomoses via intersphincteric resection in the treatment of ultra-low rectal carcinoma

Objective To evaluate the clinical value and safety of the sustaining-tube procedure for of colo-anal anastomoses via intersphincteric resection(ISR) in the treatment of ultra-low rectal carcinoma.Methods The clinical data of 21 patients with ultra-low rectal carcinoma who underwent ISR and colo-anal anastomoses with sustaining-tube ligation procedure from October,2004 to December 2009 were reviewed.Results The operation on all the cases succeeded,there was no operative death,and no stomal leakage in all the patients.The follow-up duration ranged from 6 to 68months(mean 32months).Two patients had local tumor recurrence after the operation,1 of them died.Anal stricture occurred in 2 patients,then who had undergone dilation of the anal sphincter;14 patients had satisfactory functional recovery of anus later 12 monthes after operation.Conclusion ISR and the sustaining-tube procedure for colo-anal anastomoses is suitable in the treatment of ultra-lower rectal cancer and the preservation of anal function.