低位直肠癌术前新辅助放化疗后腹腔镜下应用双吻合器技术治疗体会

目的：低位直肠癌经术前新辅助放、化疗后，肿块明显缩小，进一步提高了腹腔镜下双吻合器在低位直肠癌手术中的可行性。方法：2004年6月～2006年6月共对35例低位直肠癌病人给予术前新辅助放、化疗，在腹腔镜下用双吻合器顺利完成手术。结果：术后发生吻合15漏2例（5．7％），吻合15狭窄3例（8．6％），无切15感染及盆腔内残余感染，无手术死亡。结论：由于低位直肠癌经术前新辅助放、化疗后肿块明显缩小，以及双吻合技术的使用，帮助腹腔镜下低位直肠癌手术的顺利完成，而不需另外辅助小切口，病人恢复快，手术切除率和保肛率明显提高。

Application of double stapling technique in laproscopic surgery of low rectal cancer after neoadjuvant radiochemotherapy

Objective To evaluate the feasibility of double stapling technique in laproscopic surgery for low rectal cancer after neoadjuvant radiochemotherapy. Methods Retrospective analysis was made in 35 cases using the double stapling technique in laproscopic surgery after neoadjuvant radiochemotherapy from Jun 2004 to Jun 2006. Anastomotic lea-kage and stenosis occurred in 2 patients (5.7%) and 3 patients (8.6%) respectively. No wound and pelvic infection was observed. Conclusions The lesion in low rectal cancer diminishes dramatically after neoadjuvant radiochemotherapy. Anastomosis can be completed successfully by double stapling technique in laparoscopic surgery without extraincision. The patients recover quickly; the rate of radical tumor resection and anus preservation also could be increased.