单吻合器行低位直肠癌超低位吻合的临床研究

目的：研究利用单吻合器对低位直肠癌实施超低位吻合保肛治疗的临床意义。方法：132例肿瘤距齿状线2cm-5cm的低位直肠癌实施保肛治疗,行全直肠系膜切除,利用单吻合器实施超低位吻合。术后按吻合口距齿状线距离分为3组,齿状线组31例,0-1 cm组49例,1-2 cm组52例,观察3组生存率、并发症、局部复发率及肛门功能恢复情况。结果：全组无手术病死率,3年、5年生存率分别为85.2%、72.7%,局部复发率6.8%;经统计学检验,三组间并发症和局部复发的发生率无显著性差异;术后12个月三组肛门功能优良率分别为87.5%、93.9%、100%。结论：对于患者强烈要求保肛的低位直肠癌,在手术技巧娴熟的基础上,利用单吻合器在齿状线上2 cm内甚至齿状线处实施超低位吻合的保肛手术安全可靠,具有可行性。

The Clinical Research on Super Low Anastomosis for Lower Rectal Cancer by Single Stapler

Objective： To investigate the clinical value of the super low anastomosis for patients with low rectal cancer by single stapler.Method： 132 low rectal cancer patients which tumour leave dentation line 2cm-5cm with total mesorectal excision and super low anastomosis by single stapler.patients divided into three groups according to the space from anastomosis to dentation line： dentation line group,0-1 cm group,1-2 cm group.compared the clinical information such as survival rate and local recurrence and anal function of three groups.Result： None of patients died of operation in all groups,the 3,5 years survival rate were 85.2%,72.7%,local recurrence rate was 6.5%.No significant difference was found among the three groups of local recurrence and complication by statistics.The rate of good to fairish anal function after 12 months was： 89.5% in dentation line group,96.9% in 0-1 cm group,100% in 1-2 cm group.Conclusion： The super low anastomosis by single stapler is safe and feasible for low rectal cancer who request anus-saving operation.