结肠肛管斜形吻合治疗低位直肠癌

目的探讨中下段直肠癌保留肛门括约肌功能的最佳术式。方法对36例中下段直肠癌患者实施经腹直肠癌切除经肛门行结肠肛管前高后低的斜形吻合术。肛提肌平面距肿瘤下缘3~5cm28例,5~7cm8例。结果无手术死亡,无吻合口瘘,无吻合口狭窄。术后随访3月~5年,平均26个月,局部腹发2例(6.2%),肝转移2例。术后1月内大便次数较多,4~6次/d,3个月后排便次数及控便能力基本恢复正常。结论结肠肛管斜形吻合是直肠癌低位切除时,在确保括约肌功能的前提下,较为合理和可行的方法。

Transabdominal resection and coloanal mucosa oblique-shape anastomosis for treatment for low rectal cancer

Objective To eveluate the effects of new operative method for the treatment of low rectal carcinoma with sphincter preservation.Methods 36 casese of low rectal cancer were operated on with transabdominal resection and coloanal mucosa oblique-shape anastomosis.The distance between the muscles levator and lower margin of the tumor was 3~7cm.Results There were not operative mortality,anastomtic fistula and anastomotic stenosis in all cases.All patient were followed from 3 months to 5 years.The locay recurrence after operation accounted for 6.2%.The liver metastases was estabilshed in 2 out of 36 cases, all patient were alive and well,function of defecation returned to normal after 3 moths.Conclusion The result suggests that the method of transabdominal resection and coloanal mucomsa oblique-shape anastomosis is safe and reasonable for the treatment of low rectal carcinoma with sphincter preservation.