Nagamatsu Y, Shirouzu K, Isomoto H, Ogata Y, Tsuchida I, Akagi Y
First Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan.
Surg Today. 1998;28(7):696-700. doi: 10.1007/BF02484614.
The present study was designed to evaluate the technical feasibility and oncologic results of performing handsewn coloanal anastomosis (CAA). A total of 46 patients treated for lower rectal cancer using CAA were retrospectively studied, and the oncologic results were compared with those of 105 patients treated with abdominoperineal resection (APR). CAA was performed in patients who had both good mobility of the tumor and a distal clearance margin of more than 1.0 cm. No significant difference was noted in the mortality rates following the two operations (CAA 2.2% vs APR 1.9%). Pelvic recurrence was detected in two patients (4.5%) after CAA and in six patients (7.2%) after APR. The 5-year survival rate after CAA was 79.2% and that after APR was 72.6%. No significant difference was noted in the incidence of pelvic recurrence or the survival rates between the two operations. These results show that CAA could be an excellent reconstructive option in the treatment of lower rectal carcinoma for selected patients.
本研究旨在评估手工缝合结肠肛管吻合术（CAA）的技术可行性和肿瘤学疗效。对46例采用CAA治疗低位直肠癌的患者进行回顾性研究，并将其肿瘤学疗效与105例行腹会阴联合切除术（APR）的患者进行比较。对肿瘤活动度良好且远端切缘大于1.0 cm的患者实施CAA。两种手术术后的死亡率无显著差异（CAA为2.2%，APR为1.9%）。CAA术后有2例患者（4.5%）出现盆腔复发，APR术后有6例患者（7.2%）出现盆腔复发。CAA术后5年生存率为79.2%，APR术后为72.6%。两种手术在盆腔复发率或生存率方面无显著差异。这些结果表明，对于选定的患者，CAA可能是治疗低位直肠癌的一种极佳的重建选择。
