【摘要】 目的探讨经肛门拖出单吻合器技术在低位直肠癌保肛手术中的效果及应用价值。方法对2004年1月至2009年2月收治的低位直肠癌,75例行双吻合器保肛术(double stapling technique,DST),37例行经肛门拖出单吻合器保肛术(single stapling technique,SST)。结果两组所有患者保肛手术均获成功,无手术死亡,术后病理切缘均未见癌细胞浸润。两组手术时间、术中出血量、平均住院时间均无差异(P>0.05)。DST组发生吻合口漏3例,SST组无吻合口漏发生。随访4～65个月(平均15个月),DST组盆腔复发3例4%,吻合口复发2例2.7%,肝脏转移7例9.3%;SST组盆腔复发1例2.7%,无吻合口复发,肝脏转移4例10.8%;两组之间无统计学差异(P>0.05)。结论经肛门拖出单吻合器保肛术(SST)治疗低位直肠癌保肛成功率高,复发率低,简化了手术操作,安全可行。更多还原

【Abstract】 Objective To study the value of transanal pull-through combined with single stapling technique for anus conservation in surgical resection of low rectal carcinoma.Methods A total of 112 patients with low rectal carcinoma admitted to our hospital in January 2004-February 2009.Double stapling technique(DST)and transanal pull-through combined with single stapling technique(SST) were performed in 75 and 37 patients,respectively,to conserve anus during surgical resection of their rectal carcinomas.Results The anus of all patients was conserved with no death occurred during operation.No infiltration of cancer cells was observed at the incision margin after operation.No difference was found in operation time,blood loss and mean hospital stay time between the two groups.Anastomotic leakage occurred in 3 patients of DST group but not in any patients of SST group.The patients were followed up for 4-65 months(mean 15 months),during which recurrence of cancer in pelvic cavity and anastomosis stoma and liver metastasis were found in 3,2 and 7 patients of the DST group respectively,while recurrence of cancer in pelvic cavity was found in 1 patient but not in anastomotic stoma in any patient,and liver metastasis was detected in 4 patients of the SST group.Conclusion Transanal pull-through combined with SST is a simple and safe procedure for effective anus conservation in surgical resection of low rectal carcinoma with a low recurrence rate.更多还原