低位直肠癌双吻合器保肛术后吻合口瘘的预防

目的：探讨低位直肠癌双吻合器保肛术后预防吻合口瘘的措施。方法：回顾性分析我院行双吻合器保肛手术的76例低位直肠癌患者的资料。结果：所有病例均顺利完成手术，术后切缘病理检查均未见癌细胞浸润，无吻合口瘘及手术死亡。68例获得随访，随访时间3—52个月，平均31个月，肝脏转移5例（6．58％），其中2例分别于术后9个月及12个月行肝段切除术；盆腔复发3例（3．95％），腹腔广泛转移2例（2．63％），吻合口局部复发1例（1．32％），术后14个月再次行Miles术。结论：双吻合技术为低位直肠癌患者提供更多的保肛机会，使用得当可有效预防吻合口瘘的发生。

Prevention of anastomotic leakage after anus-preserving operation of lower rectal carcinoma with double stapling device

Objective：To explore the preventive measures of anastomotic leakage after anus-preserving operation for lower rectal carcinoma with double staphng device. Methods：The medical records of 76 cases of lower rectal carcinoma undergoing double stapling device of anus-preserving operation were retrospectively analyzed from our hospital.Results ：All operations were successfully accomplished, the incisal edge of operation was examined under light microscope and showed nothing about infiltration of malignant cell.No case was dead and complication about anastomotic leakage was not happened in all the patients investigated. 68 cases were followedup between 3 months and 52 months, average time was 31 months,the metabasis were happened to liver in 5 cases（6.58%）,and happened to cavitas abdominalis widespreadly in 2 cases （2.63%）, only 1 case had local recurrence of anastomotic stoma （1.32%） which was operated （Miles） again after 14 months. Conclusion：Double stapling technique provides more opportunities to retain anus for the patient with lower rectal carcinoma, and can effectively prevent anastomotic leakage from happening with proper use.