弧形切割吻合器在低位直肠癌保肛手术中的应用体会

目的 了解应用弧形切割吻合器治疗低位直肠癌的保肛效果.方法 回顾性分析30例低位直肠癌患者应用弧形切割吻合器治疗后其根治性、术后排便功能、手术并发症和局部复发情况.结果 本组无手术死亡,切缘均经病理证实无肿瘤细胞残留.术后出现吻合口狭窄4例(13.3%),吻合口瘘2例(6.7%),腹壁切口感染2例(6.7%),盆腔感染1例(3.3%).术后无肿瘤局部复发病例.术后排便功能基本正常.排尿功能恢复时间7-20(平均9)d.术后性功能3个月内基本恢复正常.结论 应用弧形切割吻合器对低位直肠癌的保肛手术是安全有效的.

Experience of curved cutter stapler in sphincter-preserving operation for low rectal cancer

Objective To evaluate the effect of total mesorectal excision with curved cutter stapler on low positioned rectal cancer(3～7 cm from anal verge)in the narrow pelvis.Methods Based on total mesorectal excision，30 cases of low rectal cancer in the narrow pelvis underwent sphincter preserving operation with curved cutter stapler.The 3 to 6 months follow-up result was retrospectively analyzed on radical resection effect，defecating function，complication rate and recurrent rate.Results All the resection margins were clear and the cases had no intraoperative death.Anastomotic stricture rate was 13.3％(4/30)，anastomotic leakage was 6.7％(2/30)，infection rate of incisional wound was 6.7％(2/30)， infection rate of cavitas pelvis was 3-3％(1/30) and no local recurrent case was observed.The function of patients anal sphincter was gradually recovered， and the defecation and sexual function recovered three months later.The micturition function recovered after 7 to 20 days (average 9 days).Conclusion Curability and anal function can be obtained by sphincter preserving operation.Curved cutter stapler is effective and safe for low rectal cancers in the narrow pelvis.