手工缝合闭合直肠远端在保肛手术中的应用

目的:探讨手工闭合直肠远端在保肛手术中的价值.方法:比较在直肠癌保肛手术中分别应用手工闭合直肠远端与直线缝合器闭合直肠远端两组的手术时间、出血量、吻合口漏发生率、切口感染率、切缘癌残留率、平均住院费用.结果:145例手工闭合直肠远端组(A组)平均手术时间2.5 h、平均出血量58 mL(10～300 mL)、吻合口漏发生率0%(0/145)、切口感染率(1/145)、切缘癌残留率0%(0/145)、平均住院费用12376元RMB.187例直线缝合器闭合直肠远端组(B组)平均手术时间2.3 h、平均出血量56 mL(10～300 mL)、吻合口漏发生率0%(0/187)、切口感染率(1/187)、切缘癌残留率0%(0/187)、平均住院费用14859元RMB.结论:在直肠癌保肛手术中应用手工闭合直肠远端是安全的,能达到直线缝合器闭合直肠远端的效果,虽平均手术时间稍长,但明显降低了住院费用.

Application of hand-sewn distal end of rectum in anus preserving operation for rectal cancer

Objective:To investigate the advantage of hand-sewn distal end of rectum in anus preserving operation for rectal cancer.Methods:A total of 145 cases of rectal cancer patients were received hand-sewn distal end of rectum(group A),and 187 cases of rectal cancer patients were received linear cutter(group B).The duration of operation,the amount of bleeding,the rate of anastomotic leakage,infection of incisional wound,residual margin,and cost of hospitalization were compared between the two groups.Results:There were no anastomotic leakage and residual margin in both groups.The amount of bleeding and the rate of infection of incisional wound had no significant differences between the two groups.The duration of operation was 2.5h in group A and 2.3h in group B,but the mean cost of hospitalization was 12376 yuan RMB in group A and 14859 yuan RMB in group B.Conclusion:Hand-sewn distal end of rectum in anus preserving operation for rectal cancer is not only safe and feasible,but also can reduce cost of hospitalization.