Li Shi-yong, Yu Bo, Liang Zhen-jia, Yuan Shu-jun, Chen Gang, Dong Lei
Department of General Surgery, Beijing Military Area General Hospital, Beijing 100700, China.
Zhonghua Wai Ke Za Zhi. 2003 Nov;41(11):812-4.
To investigate the reliability and feasibility of abdominal-anus resection with preservation of anal sphincter by telescopic anastomisis of colon rectal mucosa for middle-lower segment of rectal cancer.
A retrospective analysis was made for abdominal-anus resection with telescopic anastomosis of colon rectal mucosa in 102 cases of middle-lower segment of rectal cancer.
No anastomotic fistula and anastomotic stenosis occurred in the 102 cases. The increased defecation was found during early stage of postoperation, about 6-12 times per day. But this was easily controlled by antidiarrheal drugs. Twelve to 18 weeks later, defecation returned to normal. Follow-up was performed in 91 patients, and the follow-up rate was 89.2%. Mean follow-up period was 4.7 years. Local recurrence rate of the carcinoma was 5.4% (5/91), and hepatic metastasis rate was 13.1% (12/91). Three-year survival rate of postoperation was 86.9% (60/80), and five-year survival rate was 70.7% (29/41).
With telescopic anastomosis of colon rectal mucosa, colon stoma can be avoided, and anastomotic fistula can be prevented. The operation is safety and effective in preservation of anal sphincter for rectal cancer therapy.
探讨经直肠黏膜套叠吻合保肛直肠癌腹-肛门切除术治疗中下段直肠癌的可靠性及可行性。
回顾性分析102例中下段直肠癌行直肠黏膜套叠吻合腹-肛门切除术的临床资料。
102例患者均未发生吻合口瘘及吻合口狭窄。术后早期排便次数增多，每天约6～12次，经止泻药物治疗后可缓解。12～18周后排便恢复正常。91例患者获随访，随访率89.2%，平均随访时间4.7年。局部复发率5.4%（5/91），肝转移率13.1%（12/91）。术后3年生存率86.9%（60/80），5年生存率70.7%（29/41）。
经直肠黏膜套叠吻合术可避免结肠造口，预防吻合口瘘，保肛治疗直肠癌安全有效。
