低位直肠癌保肛术45例临床分析

目的探讨全直肠系膜切除（TME）在低位直肠癌保肛根治术中的临床应用价值。方法对45例低位直肠癌患者采用Heald法施行全TME保肛术的临床资料进行回顾性分析。结果45例中无死亡病例；术后吻合口漏2例，吻合口出血2例；41例患者获随访，随访率为91．1％；吻合口局部肿瘤复发4例，复发率8．9％，5年生存率70．5％。结论低位直肠癌的保肛要完全遵照全直肠系膜切除原则，必须严格选择病例，保证手术效果，最大限度保留排便功能；吻合口漏是低位直肠癌保舡术主要并发症之一；不主张不管肿瘤的分期而一味追求保留舡门。

Clinical analysis of anal preservation operation to low rectal cancer: A report of 45 cases

Objective To investigate the clinical value of total mesorectal excision (TEM) in anal preservation operation to low rectal cancer patients. Methods The data of 45 low rectal cancer patients underwent TME anal preservation operation in hospital were analyzed retrospectively. Results No patient died. 2 cases stomal leak and 2 cases stomal bleeding were found after operation. Stomal recurrence occurred in 4 cases with the recurrence rate of 8.9%. The 5-year survival rate was 70. 5%. Conclusions TEM operation principle should be stricktly complied in anal preservation operation to low rectal carcinoma. The stomal leak is the most common complication. Pursuing anal preservation operation regardless of tumour stage is not advocated.