低位直肠癌行双吻合器保肛手术

目的探讨低位直肠癌行双吻合器保肛手术的效果。方法回顾性分析近5年间应用双吻合器行保肛手术的78例低位直肠癌患者的临床资料。结果所有患者直肠闭合及吻合均成功,术后切缘病理均未见癌细胞浸润,无吻合口漏及手术死亡。73例(93.6%)随访9～65个月,盆腔复发2例(2.7%),腹腔广泛转移1例(1.4%),肝脏转移7例(9.6%),吻合口局部复发1例(1.4%,术后11个月再行Miles术)。结论双吻合技术可为低位直肠癌患者提供保肛机会,使用得当可有效预防吻合口漏等并发症的发生。

The double stapling technique in low anterior resection of rectal cancer

Objective To investigate the outcome of low anterior resection of rectal cancer with double stapling technique.Methods A retrospective analysis of clinical records of 78 rectal cancer patients who had anal preservation operation using double stapling technique was performed.Results In all of the cases,the rectal closing and anastomosis were satisfactorily completed.All the resection margins were negative for tumor infiltration.There was no operative mortality or anastomosis leakage.Seventy-three(93.6%)cases were followed up for 9-65 months,pelvic recurrence occurred in 2 cases(2.7%),multiple metastasis of peritoneal cavity occurred in 1 case(1.4%),liver metastasis was found in 7 cases(9.6%),one patient suffered from local recurrence and Miles operation was performed 11 months later.Conclusions Double stapling technique can provide more chances for sphincter preservation operation in patients with lower rectal cancer.If the technique is properly used,it also may effectively reduce the rate of anastomosis leakage and other complications.