Lazuskas T, Lelcuk S, Michowitz M, Rabau M
Surgery Dept. C, Tel Aviv--Sourasky Medical Center.
Harefuah. 1994 May 1;126(9):505-6, 563.
Between May 1989 and April 1993 we treated 108 patients, aged 44-82 years, for rectal cancer. Of them, 7 men and 2 women underwent anterior resection with colo-anal anastomosis. In this group the average distance of the tumor from the anal verge was 6 cm. Follow-up ranged from 12-48 months. There was no operative mortality. Perioperative morbidity included wound infection in 1 patient and pelvic sepsis in another; temporary disturbances in micturition occurred in 4; 1 developed an anastomotic stricture and another intestinal obstruction; 1 died of systemic spread; another was reoperated and salvaged, but had a local recurrence 3 years after the first operation. Continence was achieved in 6, while 3 had minor impairment of control. Frank incontinence did not occur. We believe that anterior resection with colo-anal anastomosis in low rectal cancer avoids a permanent colostomy, while meeting oncological and functional criteria. We advocate this procedure in selected patients with low rectal cancer.
1989年5月至1993年4月期间，我们对108例年龄在44至82岁之间的直肠癌患者进行了治疗。其中，7名男性和2名女性接受了结肠肛管吻合的前切除术。在该组中，肿瘤距肛缘的平均距离为6厘米。随访时间为12至48个月。无手术死亡病例。围手术期并发症包括1例伤口感染和1例盆腔脓毒症；4例出现排尿暂时障碍；1例发生吻合口狭窄，另1例发生肠梗阻；1例死于全身转移；另1例接受了再次手术并成功挽救，但在首次手术后3年出现局部复发。6例实现了控便，3例有轻微的控便功能受损。未发生明显失禁。我们认为，低位直肠癌的结肠肛管吻合前切除术避免了永久性结肠造口，同时满足了肿瘤学和功能标准。我们主张在选定的低位直肠癌患者中采用该手术。
