双吻合器技术在直肠癌术中的应用（附36例报告）.pdfVIP

中国肛肠病杂志 2007年第27卷第12期 · 论著与临床研究 · 双吻合器技术在直肠癌术中的应用 (附36例报告) 浙江省奉化市人民医院肛肠外科(浙江奉化31 5500) 裘小鸣 摘要 为评价双吻合器技术在结直肠癌吻合尤其是低位结直肠癌吻合术中的作用，回顾性分析36例直肠癌应用双吻合 器技术行结直肠吻合 的经验。36例术中直肠闭合和结直肠吻合过程顺利．术后发生吻合口漏2例(5。5 )，发生吻合口狭窄3 例(8．3 )，刨LI】感染 3例(8．3 )．吻合口出血1例(2．8 )。无手术死亡。结果表明，双吻合器技术能协助完成手法缝合不 易或难以完成的低位结直肠吻合术。 关键词 直肠肿瘤；结直肠外科手术；吻合器 Application of Double Stapling Technique in the Surgical Treatment of Rectal Carcinoma： Analysis of 3 6 Cases Q “Xiaoming The Colorectal Surgery of Fenghua Municipal Peoples Hospital，Fenghua，Zhejiang 315500 Abstract Effect of double stapling technique in colorectal anastomosis，especially in low colorectal anasto— InOSiS，was evaluated in the study．Data of double stapling technique in colorectal anastomosis during surgi— cal treatment of 36 cases with rectal carcinoma were analized retr。spectively．Intraoperative rectal closure and colon—rectum anastomosis were all successfu1．Postoperative anastomotic leakage was found in 2 cases (5．5 )，postoperative anastomotic stricture was found in 3 cases(8．3 )，wound infection was found in 3 cases(8．3 )，anastomotic stoma bleeding was found in 1 case and there was no death due to surgery．It is revealed that double stapling technique can help fulfill anastmosis which manual method can not or is not easy to fulfill in low colorectai anastomosis． Key Words Rectal neoplasm；Colorectal surgical operation；Stapler 近年来理论和临床实践均证实了低位直肠肿瘤 后，用直角钳在肿瘤远侧适当的部位钳闭直肠。用 保肛手术的合理性和可行性。全结肠系膜切除 0． 碘伏自肛门灌洗直角钳以下直肠后，用闭合器 (TME)原则的实施，尤其是双吻合器技术的应用， 在钳下lcm处闭合直肠，切断直肠取出病变标本。 使低位直肠癌保肛率有很大提高。笔者现将本院自 近端结肠置人吻合器的砥钉座后收紧结扎荷包线。 1 998年至今开展的双吻合器技术在36例低位直肠 扩肛后将吻合器(29～33号)置人直肠的闭合端，在 癌手术中应用总结如下。 闭合端的中心部位穿出Trocar。拖下已备好的远 1 资料与方法 端结肠，将砥钉杆对准远端直肠的Trocar插入