低位直肠癌保肛手术60例治疗体会

目的探讨直肠全系膜切除联合双器械吻合在低位直肠癌保肛术中应用效果及其实用性和安全性。方法回顾性分析2010年1月至2013年12月我院60例用全直肠系膜切除加双吻合器行保肛根治手术的临床资料。结果 60例均保肛成功,无手术死亡病例(其中32例行预防性造瘘术)。术后共发生并发症8例(13.3%),吻合口漏2例(3.3%),均为未行预防性造瘘术患者。所有并发症经保守治疗后均治愈。术后一年内局部复发3例(5%)。结论全直肠系膜切除联合双器械吻合行低位直肠癌保肛术不仅提高了保肛率且降低了局部复发率,是一种安全有效的手术方式。

Anus-Preserving Operation for Low Rectal Cancer Treatment:A Report of 60 cases

Objective To explore the feasibility of anal-preserving for low rectal cancer and the effect of total mesorectal excision （TME）with double stapling technique （DST）.Methods The clinical data of 60 cases with low rectal cancer from 2010 to 2013 were treated by low anterior resection for the rectaI carcinoma in which TME and DST were used.Results Sixty cases completed low anterior resection successfully and preserved the anus with DST.No operative death was noted.Ileostomy was performed in 32 patients. Four patients （13.3%）suffered from postoperative complications,including anastomic leakage in 2 patients （3.3%）without protective stoma.All the complications were cured by conservative treatment.One year of local recurrence was found in three cases （5%）.Conclusion TME with DST is a safe and effective operation method to reserving anus operation in lower rectal cancer.It can obviously improve the anus preserving success rate and reduce postoperative local recurrence rate.