经肛门外切除低位直肠癌保肛手术68例分析

目的 评价低位直肠癌肛门外切除、保留原位肛门、防止癌组织残留的手术疗效.方法 随访该术式后2年以上的患者68例,回顾分析相应的68份病历资料(2006年3月至2009年9月).结果 68例低位直肠癌患者随访至术后2年无手术死亡,无术后吻合口狭窄、漏、出血等;有肛管部位钛钉异物感、钛钉脱落致微量渗血现象,无局部复发;全组患者大便自控功能满意,无排尿功能障碍,性功能良好.结论 经肛门外直视下操作,能够达到理想的切除范围,单管吻合器钉合严密牢固,无双吻的"危险三角区"、原位肛门术后自控大便功能满意,相对于手工或双吻手术安全,是低位直肠癌患者保肛的一种新选择.

Sphincter-preserving operation in external anal radical resection of low rectal cancer

Objective To evaluate clinical efficacy of sphincter-preserving operation in external anal radical resection of low rectal cancer. Methods The clinial data of 68 patients with rectal cancer were analyzed retrospectively (March 2006-September 2009). Results The overall outcomes were satisfactory in all the 68 patients. There were no mortality, no anastomotic stenosis, leakage, and bleeding, in addition to no anal foreign body sensation caused by the titanium screw, no micro-bleeding due to falling off of the titanium screw, and no local recurrence within a 2-year follow-up. The 68 patients had well control of defecation and urination, and satisfactory sexual function. Conclusions External anal surgery under direct vision could achieve the desired extent of resection. Single circular stapling could be operated firmly, with no double stapler "danger dog ear"and with good control of bowel function after surgery. Compared with manual suture and double stapler surgery, it is a new choice for patients with low rectal cancer.