套入式结肠直肠黏膜吻合保肛术在肥胖患者的临床应用

目的探讨套入式结肠直肠黏膜吻合保肛术在肥胖患者中应用的可行性及安全性。方法回顾性分析2010年1月至2012年12月我院收治的128例拟行套入式结肠直肠黏膜吻合保肛术治疗患者的临床资料，按体重指数（BMI）分为A组（BMI〈25kg／m2）和B组（BMI≥25kg／m2），比较两组患者的一般资料和手术相关情况。结果两组病例在手术时间、术中出血量及保护性造口患者数等因素方面差异无统计学意义（P〉0．05），但B组转行Mile手术的患者数显著高于A组（P〈0．05）。两组病例下切缘距离，清扫淋巴结数目相比差异无统计学（P〉0．05），除了切口脂肪液化及感染这一并发症（P〈0．05），两组病例在其他术后并发症发生率及术后通气时间等方面也无明显差异（P〉0．05）。结论套入式结肠直肠黏膜吻合保肛术应用于肥胖患者是安全可行的，可达到同样的根治目的。

Sphincter-preserving surgery with colorectal telescopic anastomosis in obese patients

Objective To evaluate the safety and feasibility of sphincter-preserving surgery with colorectal telescopic anastomosis in obese patients. Methods The clinical data of 128 obese patients who received sphincterr-preserving surgery with colorectal telescopic anastomosis in our hospital from January 2010 to December 2012 were retrospectively analyzed. The patients were divided into the Group A（ BMI 〈 25kg/m2 ）and Group B（BMI~〉25kg/m2）. The general data and operation procedures were collected and compared. Results There were no significant differences in the operation time, blood loss volume and number of additional protective ileostomy（P 〉 0.05 ）. The number of cases that converted to Miles surgery were significantly higher in Group B （P 〈 0.05 ）. There were no significant differences in the distal margin, number of harvested lymph nodes, return of bowel motility and incidence of postoperative complications ex- cept for the fat liquefaction and infection of the incision. Conclusion Sphincter-preserving surgery with colorectal telescopic anastomosis is safe and feasible in obese patients, which can also achieve a result of e- radication.