低位直肠癌改良Parks术的应用研究（附33例报告）

目的 总结1990年1至1998年10月间经腹低位直肠癌切除、结肠肛管吻合术33例,探讨提高手术成功率,减少并发症的方法.方法 回顾性分析33例低位直肠癌经腹切除术,采用结肠肛管吻合术的方式及疗效,并对Parks进行改进研究.结果 33例采用经腹直肠癌切除、结肠肛管吻合术,其中根治切除32例,占96.97%,无手术死亡病例,吻合口瘘2例,占6.06%,无吻合口狭窄,随访6～84个月,盆腔复发2例,无吻合口复发病例,手术近期肛门控制稀便功能欠佳,3～6个月随访肛门功能良好.结论 低位直肠癌在保证根治的前提下,只要肛管直肠括约肌环完整,可采用该术式,手术安全,并发症发生率低,是一种理想的保肛术式.

APPLICATION OF MODIFIED PARKS PROCEDURE FOR TREATING LOW RECTAL CARCINOMA:A REPORT OF 33 CASES

Objective: To sum up the application of transabdominal excision of low rectal carcinoma and coloanal anastomosis of 33 cases in our hospital from January, 1990 to October, 1998. Methods: Thirty three patients with low rectal carcinoma had undergone the transabdominal excision and coloanal anastomosis. The operative manner and effect, the modification of Parks'operation were analyzed retrospectively. Results : Thirty three patients underwent transabdominal excision of rectal carcinoma and coloanal anastomosis, 32 cases undergone radical excision (96.97%), no operative death, 2 cases of anastomotic leakage (6. 06%), no anastomotic stenosis. A follow-up survey was carried out from 6 to 84 months. There were 2 case of pelvic recurrece no anastomotic recurrence. The anal ability to control loose stool was not good enough in a short term postop-eratively. After 3 to 6 months postoperatively the anal function was good by follow-up survey. Conclusion :If the radical excision of low rectal carcinoma can be guaranteed,and so long as anorectal sphincter is integrated, this operative manner may be adopted. The complication rate of this operation is low, so it is safe and ideal for preservation of anus.