低位直肠癌的手术治疗和吻合器的应用体会：附47例病例分析

目的 通过４７例距肛缘５～７ｃｍ低位直肠癌的分析，对距肛缘５～７ｃｍ的你位直肠癌保肛手术的理论依据、术式选择、吻合器应用的优越性和吻合器在保肛手术中的运用体会及主要并发症的防治进行了探讨。１９９４年７月至１９９７年８月作根治性手术的距肛缘５～７ｃｍ的低位直肠癌患者４７例。结果：４０例行Ｄｉｘｏｎ术式，７例行Ｍｉｌｅｓ术式。３８／４０例Ｄｉｘｉｏｎ术式应用管状端端吻合器（ＥＥＡ），其中发生直肠阴道瘘

SURGICAL TREATMENT OF DISTAL RECTAL CARCINOMA AND EXPERIENCE IN STAPLING DEVICE APPLICATION

Objective: To study the theory of anal sphincter reservation, the operative facility and experience in using stapling device, selection of surgical procedure and the management of post-operation complications through 47 cases of distal rectal carcinoma whose low borders of the cancer were approximately 5 to 7 cm from the anal verge. Clinical data: 47 cases of distal rectal carcinoma whose low borders of the cancer were 5 to 7 cm from the anal verge treated with curative resection in our hospital between July 1994 and August 1997. Results: 40 cases were performed with low anterior resection (LAR) and 7 cases with abdominoperineal resection (APR) . 38/40 cases with low anterior resection used end-to-end circumferential stapling device and there was no operative death. In these 38 cases, rectovaginal leakage occurred in 1 case and colorectal hemorrhage in 3 cases. Conclusion: It's possible for sphincter-sparing operations to distal rectal carcinoma whose low borders of the cancer were 5 to 7 cm from the anal verge. We believe that stapling device play an important role in sphincter-sparing operations and the application of stapling device is worthy of wide use.