保肛根治术治疗直肠癌患者临床效果分析.docVIP

保肛根治术治疗直肠癌患者的临床效果分析 　　摘要：目的 探讨低位直肠癌保肛手术治疗直肠癌的临床应用和疗效评价。方法 回顾分析我院2004年3月～2007年5月间收治的48例直肠癌患者进行保肛根治术的临床资料，通过分析保肛根治术的应用，疗效评价，术后并发症，复发率和1年、3年、5年生存率，并与同期收治的45例经传统Miles术式治疗的患者来比较二者疗效。结果 48例直肠癌患者行直肠吻合术均一次成功，无手术中死亡。术后发生吻合口瘘并发症 3 例，吻合口狭窄4例，术后吻合口出血患者2例，均经保守治疗治愈。复发9例，其中吻合口复发6例，盆腔复发3例。对患者进行长期随访，1年、3年、5年生存率分别达到91.7%、81.3%、66.7%。与经Miles术式治疗的45例患者比较，患者保存肛门排便功能，术后生活质量提高，在复发率和术后生存率方面无显著差异，P0.05。结论 应用吻合器对低位直肠癌患者实施保肛根治术，成功率高，疗效好，并发症少，术后生活质量高等优势，与传统的Miles术式比较，在术后生活质量方面具有显著优势，同时并未增加复发率和降低生存率。值得在临床上推广应用。 　　关键词：低位直肠癌；保肛根治术；吻合器 　　Abstract：Objective To investigate the clinical application and efficacy of anus-preserving radical resection in treatment of patients with lower rectal carcinoma. Methods Clinical data of anus-preserving radical resection，which were performed on 48 cases with lower rectal carcinoma by peforming anus-preserving radical resection during Mar，2004 through May，2007，were retrospectively analyzed.To evaluate the efficacy of anus-preserving radical resection by analyzing the application ，efficacy，complication relapse rate and survival rate of 1year，3years and 5 years.And to compare the treatment effect between the patients receiving anus-preserving radical resection and traditional Miles. Results 48 cases who received anus-preserving radical resection were all successfully once，no patient died during operation.Postoperative anastomosis fistula and stenosis occurred in 3 cases，and 4 cases respectively， while postoperative anastomotic bleeding occurred in 2 cases.All complication were cured by conservative treatment. 9 cases relapsed，6 cases of them occurred in anastomosis and 3 others occurred in pelvic cavity. To conduct a long-term follow-up and the survival rate of one-year，three years and five years were 91.2%，80.9% and 66.2%. Compared with the traditional miles ，the patients keep defecation function and improve postoperative quality of life，meanwhile，they it has no significant difference in relapse rate and survival rate. Conclusion The application of？ stapling de