Dimitrov V, Dudunkov Z, Ralchev K, Kurtev P
Khirurgiia (Sofiia). 1990;43(4):85-91.
A new type of abdomino-transanal resection of the rectum instead of its extirpation is being applied in tumors localized in the proximal part of the lower one third of rectum (5-6 cm from the anorectal line). For removing the whole lymph collector of the lower one third of the rectum the authors remove the levator tunnel as well. What remains intact is only the anal mucosa and the external anal sphincters. The anastomosis is realized by preliminary placing all catgut. Prophylactic transversostoma is also an obligatory procedure, so that the anal sphincters may remain at rest for 2-3 months after the operation. During this time the anal sphincters and the neorectum are fixed to the adjacent tissues and the anal tonus is fully restored. This operation was applied in 15 patients with very good result, as regards anal continence, without any case of relapse of the tumor so far.
一种新型的经腹经肛门直肠切除术(而非直肠切除)正应用于位于直肠下三分之一近端(距肛门直肠线5 - 6厘米)的肿瘤。为了切除直肠下三分之一的整个淋巴收集器,作者还切除了提肌隧道。仅保留完整的肛管黏膜和肛门外括约肌。通过预先放置所有肠线来实现吻合。预防性横结肠造口术也是一项必要的操作,以便术后肛门括约肌能够休息2 - 3个月。在此期间,肛门括约肌和新直肠固定于相邻组织,肛门张力完全恢复。该手术应用于15例患者,在肛门节制方面效果非常好,迄今为止尚无任何肿瘤复发病例。