【摘要】 目的　本文针对中、下段直肠癌,在不影响根治原则的基础上,设法保留或重建肛门功能,避免腹壁造瘘的手术。方法　自1995 - 0 8～2 0 0 4 - 10 ,共施行直肠癌根治术86例,其中行保肛手术4 8例。结果　术后肛门功能恢复情况,以低位前切除术最佳,股薄肌移植术若手术成功,功能恢复亦称满意。许多学者曾经将Dixon手术改良演变成其他多种术式如各种拖出式吻合,但吻合器可以完成在直肠、肛管任何位置的吻合,所以,结肠拉出术在临床上较少采用。结论　适应证选择应以早、中期、病变局限、深度不超过肌层,术中探查无明显区域淋巴结转移的高、中分化腺癌为主。依据病变占居部位,采用不同的手术方式。更多还原

【Abstract】 Objective To discuss how to preserve the anus or restore the anal function in the treatment of middle or lower rectal cancer, without violating the principle of radical resection or to avoid and abdominal artificial anus. Methods 86 cases of rectal cancer were operated with radical resection, 48 of which were operated with preservation of anus from August 1995 to October 2004. Results Based on close observation of the patient, postoperative anal function seemed that Dixon’s anterior approach was first choice. Under circumstance of success of trans-plantation of the gracilis muscle, satisfactory resection and function were always possible. Many scholars ever reformed Dixon’s resection with lots of operative procedures, such as Bacon’s resection. Because stapler could joint rectal and anal together at any section, Bacon’s resection was adopted less in the clinical practices. Conclusion The indications for anus preserving operation were as followed: 1, early or middle stage disease of the bowel; 2, no metastatic regional lymphadenopathy and 3 adenocarcinoma with high or moderate degree of differentiation. It suggested that different types of operative procedures should adopt according to the location of the lesion.更多还原