改进原位肛门整形重建术的临床研究

目的探讨采用改进的四联术原位肛门整形重建术的效果。方法38例低位直肠癌行Miles根治术后行一期改进的四联术原位肛门整形重建术,改进包括:①肛门内括约肌改进为双层双套环;②肛门外括约肌改进为肛门外括约肌浅部与深部重建;③直肠角改进为肛提肌切缘牢固地缝合于肛门括约肌外面与结肠前壁;④直肠瓣改进为三个人工直肠瓣。结果38例术后肛门外形、功能及远期生存率均更为优良,术后肛门功能测试的总优良率达94·73%,远期生存率高达76·32%。结论改进的四联术原位肛门重建术的效果良好,改进术式的设计也更符合正常解剖结构与生理功能。

Clinical research of improved plastic and reconstruction of anus in situ

OBJECTIVE: To explore the effect of the improved plastic and reconstruction of the anus in situ. METHODS: Improved plastic and reconstruction of anus in situ was performed in 38 cases of low rectal cancers operated while Miles radical operation. Imoprovement inclucles: (1) The internal sphincter was rebuilt with 4 layers of muscle layer of the endmost of colon. (2) The last of gracili was divided into 2 parts to reconstruct the superficial part and deep part of external sphincter muscle. (3) The rectum cape improvement is to firmly stitch the levator ani outside the external sphiniter muscle in front of the colon. (4) The rectum valvel is improved into three artoficial retum valvels. RESULTS: The form and function and their long term survival rate were good, the rate of superior anus function was 94.73%. CONCLUSION: It mains the results of improved plastic and reconstruction of anus in situ is near that of normal persons.