超低位直肠癌切除单吻合器结肠肛管吻合42例分析

目的探讨超低位直肠癌保肛手术的可行性及其手术方式。方法对我院2001年1月-2006年12月收治的超低位直肠癌42例的临床病理特点、吻合方式、术后肛门功能及预后情况进行回顾性分析。结果本组术后发生吻合口瘘3例。局部复发4例，其中，Dukes B期2例，C期2例。本组5年生存率为60％，Dukes A、B、C期的5年生存率分别为75％、69．5％和27．2％。病人术后1月内排便功能普遍较差，6个月后趋于正常，无一例大便失禁。结论对于肿瘤局限、分化良好、身体情况良好的超低位直肠癌病人可以采用单吻合器行保肛手术。

Analysis of rectosigmoidectomy in 42 ultra low rectal cancer patients undergoing coloanal anastomosis by single stapler

Objective To investigate the feasibility and therapeutic strategy in ultra low rectal cancer patients undergoing sphincter preservation operation.Methods The clinical data of 42 cases of ultra low rectal cancer at Suqian People's Hospital from 2001-2006 were retrospectively analyzed.Outcomes were assessed by clinicopathological features,anastomosis method,anus function and prognosis.Results Coloanal anastomosis with single stapler was performed.The total 5-year survival rate was 60%,and that in dukes A,B and C stage was 75%,69.5% and 27.2% respectively.Anastomatic leakage occurred in 3 cases,and local recurrence occurred in 4 patients.Postoperative defecation function was bad within one month and turned better after 6 months.No encopresis was found.Conclusion For the patients with ultra low rectal cancer,it was feasible to execute sphincter preservation operation by single stapler for the tumor was located and better differentiated.