吻合器用于低位直肠癌保肛手术30例疗效分析

目的探讨吻合器在低位直肠癌保肛手术中的应用方法和临床疗效。方法在全直肠系膜切除的基础上,30例肿块下缘距肛缘4～7cm的低位直肠癌患者应用双器械吻合技术及荷包缝合直肠远端、管状吻合器吻合,随访5个月～3年,分析其根治性、术后排便功能、手术并发症、局部复发率。结果 30例均吻合成功,无切端癌残留,无大便失禁,1例出现吻合口瘘;全组无手术死亡;肿瘤局部复发率为6.7%（2/30）。结论利用器械吻合技术、全直肠系膜切除行低位直肠癌保肛手术是保持排便功能、减少并发症、减少局部复发、提高生活质量的有效方法。

Application experience of stapler in the operation of anus preservation on low position rectal cancer

Objective To investigate the specific method and clinical effect of stapler in the operation of anus preservation on the low position rectal cancer.Methods On the basis of TME(total mesorectal excision),using double stapling technique combined with purse string suture distal and tubular stapling,30 cases with low position rectal cancer whose lower edge of tumor were 4-7 cm to the anal verge were analyzed,including of the radical care effect and the function of defecation,local reccurrence.All the cases had been followed up for 5 months to 3 years.Results 30 cases were performed with ultralow colorectal anastomosis.There was not tumor remaining,there were not incontinence of feces in the group,and there was no operation death.There was 1 case of leakage of anastomotic opening,and local recurrence rate was 6.6%(2/30).Conclusion Total mesorectal excision combined with stapling technique in the operation of anus preservation on the low position rectal cancer is not only to maintain function of defecation,reduce complications,reduce local reccurrence,but also to improve the living quality of patients.