Danis J
Department of Surgery, General Public Hospital, Hainburg an der Donau, Austria.
Hepatogastroenterology. 1998 May-Jun;45(21):771-2.
BACKGROUND/AIMS: Sphincter saving deep anterior rectumresection improved the live quality of the rectal cancer patients. With the technical progress the resection level could be moved significant distally. The initial experiences are referred with the use of the stapler with flexible shaft in six patients operated due to very deep rectal cancer.
After the usual rectum mobilization the Proximate access AX55 mm (Ethicon) is positioned onto the stretched rectum. The flexible shaft has to be curved to the front and the jaw has to be angled parallel to the handle. The partially closed jaw of the stapler is then pushed towards the anus and then fired. The rectum is the resected. The operation is completed with EEA stapled anastomosis.
Excellent results in all six patients could be noticed 3-18 months after the procedure. No cancer recurrence occurred. Functional sphincter investigation was performed in two patients with result of physiologic sphincter function. Stolen frequency has been stabilised between 2-8 a day.
Improved transabdominal stapled method of rectum resection guarantees comfortable and oncologically safe resection of the distal rectum with maintenance of the sphincter function.
背景/目的：保留括约肌的直肠深前切除术提高了直肠癌患者的生活质量。随着技术进步，切除平面可显著向远侧移动。本文介绍了使用柔性轴吻合器对6例因直肠癌位置极深而接受手术的患者的初步经验。
在常规游离直肠后，将55mm的Proximate access AX（爱惜康公司）放置在伸展的直肠上。柔性轴必须向前弯曲，钳口必须与手柄平行成角。然后将吻合器部分闭合的钳口推向肛门并击发。切除直肠。手术通过EEA吻合器吻合完成。
术后3 - 18个月，所有6例患者均取得了良好的效果。无癌症复发。对2例患者进行了括约肌功能检查，结果显示括约肌功能正常。排便频率稳定在每天2 - 8次。
改良的经腹直肠吻合器切除术保证了低位直肠癌的舒适且肿瘤学安全的切除，并维持了括约肌功能。
