低位直肠癌应用经肛门拖出单吻合器技术保肛的临床研究.docVIP

低位直肠癌应用经肛门拖出单吻合器技术保肛的临床研究 魏正强、张才全、朱明才、张宏宇、张军、王子卫 （400016 重庆 重庆医科大学附属第一医院胃肠外科） 【摘 要】 目的 探讨经肛门拖出单吻合器技术在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-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））ransanal pull-through combined with single stapling technique for anus conservation in surgical resection of low rectal carcinoma WEI Zheng-qiang, ZHANG Cai-quan, ZHU Ming-cai, ZHANG Hong-yu, ZHANG Jun, WANG Zi-wei（Department of General Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China） 【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 si