双吻合器在低位直肠癌保肛手术中的应用

目的 探讨双吻合器在低位直肠癌保肛手术中的应用.方法 回顾性分析79例应用双吻合器行保肛手术的临床资料.结果 全组79例均行根治性手术,元一例死亡.术后发生吻合口瘘2例(2.5%),吻合口狭窄3例(3.8%).术后排便功能加做结肠末端粪袋成形者效果佳.5年生存率63.3%,吻合口局部复发8例(10.1%),盆腔软组织复发4例(5.1%).结论 低位直肠癌的保肛手术在双吻合器的帮助下能够完成,且不影响5年生存率和局部复发率,辅助性的结肠末端粪袋成形术,有利于改善术后的排便功能.

Application of double stapling device in anus-preserving operation of low rectal cancer

Objective To investigate the role of double stapling device in anus-preserving operation of low rectal cancer. Methods Retrospective study was used to analyze the experience of double stapling device in anus-preserving operation of low rectal cancer for 79 patients between March 1999 to March 2003. Results 79 cases in the group all had the radical resection, no patient died. Complications included anastomosis fistula in 2 patients(2.5%),anastomosis stenosis in 3 patients(3.8%). The defecation function after surgery,the patients who received colonic Jpouch or transverse coloplasty pouch were much better than those not did. Five years survival rate 63.3 %, anastomosis recurrence rate 10.1% and recurrence rate in the pelvic soft tissue was 5.1%. Conclusion Anus-preserving operation of low rectal cancer can accomplished with double stapling device,and five years survival rate and local recurrence rate did not effect. Colonic J-pouch or transverse coloplasty pouch is good for improving the defecation function after anus-preserving operation.