直肠切除,结肠肛管吻合术治疗中下段直肠癌

１９８６年至１９９３年６月，作者采用直肠切除、结肠肛管吻合术（ＣＡＡ）共治疗中下段直肠癌３９例，初步疗效满意，认为传统的预防性结肠造口可考虑省去，降低ＣＡＡ术后吻合口瘘的关键在于吻合时的仔细操作和保持吻合口的绝对无张状态。有关ＣＡＡ的适应证作者认为：分化程度较高（Ｇ１、Ｃ２），肿瘤下方可切除３ｃｍ以上肠管的直肠癌病人更为适宜。

Treatment of middle and lower rectum cancer by rectum resection and coloanal canal anastomosis

Thirty-nine patients with middle and lower rectum cancers have been treated by rectum resection and colonal canal anastomosis since 1988.The preliminary results prove satisfactory,and the authors consider the traditional preventive laparocolostomy unnecessary.The key points in lowering the rate of anastomotic fistula lie in careful management and keeping the anastomosis in absolute absence of tension. The authors believe that patients with higher diff erentiated tumors(G1,G2) and the anal canal with more than 3 cm resectable are plausible candidates.