腹膜反折以下直肠癌保肛扩大根治术

报告68例低位直肠癌中，选择54例在扩大根治术基础上采用经肛门秋扎式结肠—直肠(肛管)吻合术．保肛率占低位直肠癌的70．3％．54例保肛手术中上方淋巴结转移率52．4%，侧方转移率20.2%，下方转移率0%．转移度8.7%，吻合口漏1例．吻合口狭窄3例。术后随访1～3年，未见局部复发，术后排便功能良好率占80％，说明低位直肠癌通过实施扩大根治术，保证盆腔无复发可能的前提下，实施保肛手术是可行的．对低位直肠癌保肛手术理论、手术适应证选择，手术操作要点及远期效果加以探讨。

EXTENDED RADICAL SURGICAL OPERATION UNDER PERI-TONEAL REFLECTION AND PRESERVATION OF ANAL SPHINC-TER IN RECTAL CARCINOMA

This article reported 68 low rectal carcinoma cases, in which 54 cases each re-ceived a rectal tube with an encircling ligature wire tied tightly to make cdon-rectum (anal canal) anastomosis(79. 3%). The upper lymph node metastatic rate was 52. 4%, lateral metastat-ic rate 20.2%, and under metastatic rate 0%; anastomotic leakage in one case, and anastomotic stricture in 3 cases. The patients were followed up for 1 to 3 years. There was no local recurrence, and good defecation function in 80% cases. These results justify the application of extended radi-cal surgical operation with preservation of the anal sphincter in low rectal carcinoma. The reasons for the application of extended radical surgical operation with preservation of the anal sphincter in low rectal carcinoma, the indications for operation, the main points in the operation procedures and the long-term therapeutic effect were also discussed.