不同吻合技术在腹腔镜低位直肠癌保肛手术中的对比研究

目的:探讨各种吻合技术在腹腔镜低位直肠癌保肛手术中的应用价值。方法:回顾分析2003～2010年腹腔镜下利用不同吻合技术施行52例低位直肠癌保肛手术的临床资料。结果:52例手术均获成功,无中转开腹,术后肠管切缘病理切片均无癌浸润,其中利用双吻合器吻合技术12例,腹腔镜下荷包缝合直肠残端用吻合器完成结直肠吻合16例,肛门外拖出直肠远端闭合再用吻合器完成结直肠吻合14例,经肛门拖出式手工吻合10例。结论:消化道吻合技术是腹腔镜低位直肠癌保肛手术的技术难点,掌握不同的吻合技术可缩短腹腔镜直肠癌保肛手术的学习曲线,提高保肛率。

Comparative study of different stapling techniques in laparoscopic anus-preserving operation for lower rectal cancer

Objective:To explore the application value of different stapling techniques in laparoscopic anus-preserving operation for lower rectal cancer.Methods:The clinical data of 52 lower rectal cancer patients who underwent laparoscopic anus-preserving operation with different stapling techniques from 2003 to 2010 were retrospectively analyzed.Results:All 52 cases were successfully operated with no conversion to open surgery.No cancer cells were found in the incisal edge of the specimen.In this group,12 were managed by double stapling device,16 were treated with modified Dixon operation by stapling techniques,14 were treated with transanal pull-through combined with single stapling technique,10 cases underwent manual anastomosis by transanal pull-through technique.Conclusions:Anastomosis technique of alimentary tract is the key and difficult point in laparoscopic anal preserving resection for low rectal cancer,mastering different anastomosis techniques can shorten the learning curve of laparoscopic anal preserving resection for low rectal cancer and improve anal preserving rate.