【摘要】 目的探讨保肛手术方法治疗老年人低位直肠癌的效果。方法选择老年低位直肠癌56例,以Heald等提出的“直肠系膜全切术”(TME)的原则,肿瘤下缘切除肠管3～4cm,DukesA期中4例1cm。直肠前切除端端单层吻合术26例;直肠经腹切除结肠肛管吻合术30例。术中保证吻合无张力,吻合口部位血运良好。结果手术时间最长175min,最短125min,平均150min。随访中4例局部复发(分别在术后8、12、14、21个月),占8.9%。无1例发生吻合口漏。本组术后生存5年者43例,占76.8%,生存10年者17例,占30.5%。结论保肛手术可缩短手术时间,提高老年人术后生活质量,不增加局部复发率。更多还原

【Abstract】 Objective To explore method of preserving anus in the operation of low rectal carcinoma of the aged,and to expound its reasonability.Methods Fifty-six aged patients with low rectal carcinoma were selected.Based on the principle of total mesentery excision (TME),which was put forward by Heald et al,in the low end of neoplasm3-4cm rectum was cut off;for Dukes A was1cm,in4patients.Operation procedure:①single layer anastomosis in the front end resection of recta,in26cases;②anastomosis of anus and colon in the operation of rectal cutting through stomach,in30cases.It was insured that there was no tensile stress in the anastomosis and the blood support at anastomosis open ing was well.Results The average duration of the operation was150min,the longest duration was175min and the shortest duration lasted125min.The four cases(8.9%)recurred later8,10,14and21months after operation.The5year’s survival rate was76.8%(43/56);10year’s,30.5%(17/56).And there was not anycase of anastomotic leakage.Conclusion The anus -preservation operation can cut down the time of operation,strengthen the safety of operation,improve the life quality of the aged,shorten the recurrence rates.更多还原