支撑吻合管吻合法用于低位直肠癌保肛手术的临床研究

为探讨支撑吻合管吻合法用于低位直肠癌保肛手术的效果，本研究将102例肿瘤下缘距肛缘4～6cm的低位直肠癌拟行保肛手术者随机分为治疗组和对照组，各51例，治疗组术中采用支撑吻合管吻合法吻合肠管，对照组采用管状吻合器吻合法吻合肠管，对比两组患者术后吻合口漏及肛门坠胀不适发生率。结果显示，治疗组术后无一例发生吻合口漏；对照组发生吻合口漏5例（9．8％），其中1例经保守治疗后症状缓解，4例行吻合口漏修补术。治疗组术后吻合口漏发生率明显低于对照组，P〈0．05。术后随访，治疗组患者诉肛门坠胀不适6例（11．8％），对照组15例（29．4％），两组比较差异亦有统计学意义，P〈0．05。结果表明，支撑吻合管吻合法可有效降低低位直肠癌保肛手术后吻合口漏的发生率，且可减轻患者肛门坠胀不适症状，值得临床推广应用。

Clinical Study on Support-anastomosis Tube Used in the Preserved-anus Procedure for Low Rectal Carcinoma

This study was to explore the efficacy of support-anastomosis tube used in the preserved-anus procedure for low rectal carcinoma,randomly divided the 102 patients to he received the preserved-anus procedure for their low rectal carcinoma which the lower-dege of neoplasm body was 4-6cm far from the anus-edge into treatment group and control one, n = 51 for eaeh;in the former this support-anastomosis tube was used in the operation to anastomose intestinal canals,while in the latter tube-like stapler used to do so,then,after operation the incidence of stoma leakage and the uncomfortable sensation of anus tenemus were compared between both groups.As results, the incidence of stoma leakage in treatment group was sig- nificantly lower than that in control group（0 case ： 5 cases,0 ： 9.8%, P 〈0.05）,which among the 5 cases of control group 1 ease was treated conservatively up to symptom relief,rest 4 cases received repair proce- dure for leakage ; postoperative follow-up found in treatment group 6 cases（11.8%） being of uncomfortable sensation of anus tenemus and in control group 15 cases（29.4%） ,which there was statistical difference（ P 〈0.05）.Results show that this support-anastomosis tube can effectively reduce the incidence of stoma leak- age,and relieve the uncomfortable symptoms of anus tenesmus,thus it is worthy to be popularized to use clinically.