单层缝合吻合法和吻合器吻合法在低位直肠癌保肛手术中的应用对比研究

目的　探讨单层缝合手法吻合在低位直肠癌保肛手术中的应用价值。方法　 96例我院择期行低位直肠癌保肛手术患者 ,随机双盲分为 2组 ,单层缝合手法吻合组 5 4例 ,以吻合器吻合组4 2例为对照 ,对术后吻合口并发症及患者肛门排便功能进行了对照研究。结果　单层缝合手法吻合组 5 4例无吻合口漏及狭窄。术后排便功能控制好 ,局部复发 2例。吻合器吻合组 4 2例无吻合口漏 ,但 7例发生吻合口狭窄 ,需服用缓泻剂协助排便及扩肛治疗。 2例发生吻合口出血 ,局部复发 2例。结论　单层缝合手法吻合具有操作简便易行 ,经济安全 ,术后并发症少 ,排便功能控制好的优点 ,在低位直肠癌保肛手术中仍占有重要地位

Comparison of one-layer suture manual technique and stapled anastomosis in the anus reserved operation of low rectal cancer

Objective To evaluate the value of the one-layer suture manual technique in the anus reserved operation for low rectal cancer. Methods 96 patients rectal cancer, after were randomly divided into two groups after radical operation. One-layer suture manual technique was performed 54 cases and stapled anastomosis group in 42 cases. The postoperative complications and defecational function were compared in the two groups. Results 54 cases with the one-layer suture manual technique have no anastomotic leakage and stenosis, their anal sphincteral funtion was controlled well, local recurrence of cancer in 2 cases. There was no anastomotic leakage in 42 cases with stapled anastomosis, but 7 cases had anastomotic stenosis(16 66%) and were cured by mild purgative and anal dilation. Anastomotic hemorrhage developed in 2 cases with stapled anastomosis. Locally recurred cancer was found in 2 cases. Conclusions One-layer suture manual technique is safe and convenient. Few complications developed and anal sphincteral funtion is controlled well after operation. It's still an important procedure in the anal sphincter reserved operation for low rectal cancer.