内括约肌切除术治疗超低位直肠癌11例的临床分析——附血清中Fer和CEA水平的考核

目的 探讨经腹及肛门内括约肌切除术（intersphincteric resection,ISR）的直肠癌根治保肛术治疗超低位直肠癌的临床疗效.方法 11例病灶下缘距齿状线不足2cm或距肛缘不足5cm的超低位直肠癌进行术前评估,经腹及肛门切除肛门内括约肌保肛术进行回顾分析,并进行了血清中铁蛋白（Fer）和CEA的考核.结果 无手术死亡病例,仅有1例并发症,平均随访24个月,均无发现局部复发,所有病人术后6个月～1年肛门功能恢复满意,血清Fer和CEA亦降至正常水平.结论 ISR是一种可选择的治疗超低位直肠癌的根治性保肛方法.

Clinical Analysis of Intersphincteric Resection for Ultra Low Rectal Tumor:An Analysis of 11 Cases with the Serum Fer and CEA Levels Testing

Objective To evaluate anus-preserving procedure of intersphincteric resection（ISR） for the treatment of ultra low rectal tumor through a combination per anum-abdominal approach.Methods 11 patients with ultra low rectal tumor whose distal tumor edges were less than 2cm from the dentate line or 5cm to the verge of anus underwent were evaluated preoperatively.Anus-preserving procedure of intersphincteric resection through a combination per anum-abdominal approach and determined the serum Fer and CEA levels.Results There was no perioperative death and the post-operative morbidity was 9.09%（1 case）.The average time of follow-up was 24 months.No evidence of local recurrence.They were satisfied with their fecal control after 6 months and the serum Fer and CEA levels were down.Conclusion ISR is an alternative sphincter-saving procedure for the redical resection of ultra low rectal tumor.