两种不同术式在低位直肠癌保肛术中的应用效果分析

目的探讨两种不同术式对低位直肠癌保肛手术的应用效果。方法选择肿瘤下界距肛缘4～7 cm低位直肠癌患者58例按随机数字表法分为研究组和对照组，每组29例，研究组行双吻合器Dixon低位前切除术；对照组行常规Miles手术。对两组手术时间、5年生存率、局部复发率、并发症发生率、排便功能和控便能力进行对比研究。结果研究组手术时间( 180±56) min，明显低于对照组（240±73）min](P＜ 0.05)。研究组5年生存率为77.9％，局部复发率为6.9％(2/29)，对照组分别为79.3％、6.9％(2/29)(P＞ 0.05)。研究组术后排便功能恢复良好，术后大便≤5次/d，而对照组丧失控便能力。结论对于肿瘤下界距肛缘4～7 cm的低位直肠癌患者，只要有保肛手术的适应证，双吻合器Dixon保肛手术可获得与Miles手术相似的近期疗效，且具有更好的控便能力。

Analysis of the effect of two techniques on sphincter saving procedure for treating low rectal carcinoma

Objective To investigate the clinical effect of the double stapling technique for anus-preserved (Dixon) and Miles procedure of rectal carcinoma. Methods Fifty-eight cases were divided into 29 cases as control group and 29 cases as observation group by digital table method. The distance of their carcinoma was 4-7 cm to anus. The control group was treated with Miles procedure of rectal carcinoma, the observation group was treated with double stapling technique for Dixon. Results The operation time of observation group was ( 180 ± 56) min, the control group was (240 ± 73)min(P ＜ 0.05). Five-year survival rate of observation group was 77.9％, the control group was 79.3％ (P ＞0.05);the recurrence rate of observation group was 6.9％(2/29),the control group was 6.9％(2/29) (P ＞ 0.05). In the observation group,nobody suffered encopresis after 1 year,postoperative stool frequency was ≤5 times/d,while the control group occurred encopresis gradually. Conclusion If the distance of carcinoma is 4-7 cm to anus, the way of the double stapling technique for Dixon can get the similar short term effect with the way of Miles, and can get more ability to control it.