全直肠系膜切除双器械吻合治疗低位直肠癌

目的探讨双器械吻合技术联合全直肠系膜切除在低位直肠癌保肛手术中的应用和疗效. 方法在全直肠系膜切除的基础上,应用双器械吻合技术,对53例低位直肠癌行低位或超低位吻合.随访3年,回顾性分析其根治性、术后排便功能、手术并发症、局部复发率. 结果低位吻合12例,超低位吻合41例.无切端癌残留,全组无手术死亡,无吻合口漏.本组均随访3年,6个月内每日大便次数5～10次者18例,余者均在5次以下,6个月后所有患者大便次数均在5次以下,无大便失禁.吻合口狭窄发生率3.8%(2/53),肿瘤局部复发率5.7%(3/53). 结论在全直肠系膜切除基础上,利用双器械吻合技术行低位直肠癌保肛手术是保持排便功能,减少并发症,减少局部复发,提高生活质量的有效方法.

Combined Application of Double Stapling Technique and Total Mesorectal Excision for Low Positioned Rectal Cancer

Objective To investigate the specific procedure and therapeutic effect of combined application of double stapling technique(DST) and total mesorectal excision (TME) for low positioned rectal cancer. Method 53 cases of low positioned rectal cancer underwent surgery with DST for low or ultralow anastomosis, the 3-year follow-up result was retrospectively analyzed on radical resection effect, defecating function, complication rate and recurrent rate. Results Low anastomosis and ultra-low anastomotic were perfromed in 12 and 41 cases respectively. All the resection margin were clear and no occurrence of incontinence, anastomotic leakage or intraoperative death. Both anastomotic stricture rate and local recurrent rate were 3.8%(2/53) and 5.7(3/53) respectively. Conclusions Combined application of DST and TME for low positioned rectal cancer is effective in maintaining defecating function, lowering complication rate, decreasing recurrent rate and improving life quality.