?????????????λ????????????е???ã???35????????

目的　探讨结肠肛管吻合术在低位直肠癌术中的保肛作用及一些相关问题。方法　回顾性分析北京协和医院外科 1991年 5月至 2004年 10月共 35例低位直肠癌行结肠肛管吻合术的临床资料。结果　全组手术进程顺利,术后发生吻合口漏和吻合口出血各 1例。按Parks制定的标准,术后肛门功能优良率为 84. 4%。肿瘤术后局部复发率为 5. 7%, 3年存活率为 87 .5%, 5年存活率为 65. 4%。结论　结肠肛管吻合术作为保肛手术的一种术式可用于普通手术时无法保留肛门的低位直肠癌病人。

The role of the sphincter preserving surgery with per-anal coloanal anastomosis in low rectal cancer:report of 35 cases

Objective To evaluate the role of the sphincter preserving su rgery with per-anal coloanal anastomosis between the colon and anal canal in th e low rectal cancer and some problems related to the operation.Methods The clinical data of 35 patients with low rectal cancer who underwent per-anal coloanal anastomosis at Peking Union Medical College Ho spital from May 1991 to October 2004 were reviewed. Results All the operations were performed smoothly.Complicatio ns included anastomotic leakage and anastomotic bleeding in one case respectivel y.According to the criterion of anal function by Parks,the satisfactory rate of anal function after operation was 84.4%.Local recurrence rate was 5.7%.The 3- year and 5-year survival rates were 87.5% and 65.4%,respectively.Conclusion When sphincter preserving surgery isn' t performed b y common operations in the low rectal cancer,per-anal coloanal anastomosis is a lways firsth to be performed in sphincter preserving surgery.