经肛门拖出式切除并双吻合器技术在超低位直肠癌保肛术中的应用

目的探讨经肛门拖出式切除并双吻合器吻合在超低位直肠癌全直肠系膜切除术中的应用价值。方法回顾性总结19例超低位直肠癌保肛手术的经验。结果本组病例利用全直肠系膜切除技术,充分分离直肠并离断肿瘤近端后经肛门拖出,直线型闭合器切闭肿瘤远端,圆型吻合器行端端吻合,均成功保肛,术后病理检查残端无肿瘤遗留,发生吻合口漏1例（5.3%）,切口感染1例（5.3%）,无手术死亡。结论在全直肠系膜切除的基础上,经肛门拖出式切除并结合双吻合器技术行超低位直肠癌保肛术是安全可靠的,它可以大大提高超低位直肠癌保肛手术的成功率。

The Application of Pull-out Resection Through Anal Canal with Double Stapling Technique in Anus-Conserving Operation for Extra-low Rectal Cancer

Objective To discuss the application of pull out resection through anal canal with double stapling technique in total mesorectal excision for extra-low rectal cancer.Methods A retrospective review was made to 19 cases with extra-low rectal cancer treated by anus-conserving operation.Results Total mesorectal excision for rectal cancer was performed to all the 19 cases;the rectum was thoroughly separated,cut off at the proximal end and pulled out through anal canal;linear type closer was applied to close the distant end to the tumor;then end to end anastomosis was made with circular stapler,the anus was successfully conserved;pathological examination after operation showed no residual carcinoma in stumps;anastomotic leakage was found in 1 case(5.3%),incision infection in 1 case(5.3%),no death. Conclusions It is safe and reliable to apply pull-out resection through anal canal with double stapling technique in total mesorectal excision and it can greatly raise the successful rate of anus-conserving operation for extra-low rectal cancer.