论文部分内容阅读
我院自1987~1995年采用人工直肠瓣和人工内括约肌保肛术治疗低位直肠癌60例,其操作方法是在乙状结肠吻合端3cm以上处,将肠管前壁对褶缝合3cm,制成与结肠带呈45°的人工斜行瓣(即人工直肠瓣),再将备好的8cm长结肠浆肌片环包裹缝在以人工直肠瓣为中心的全肠壁上。其吻合方法有:方法1用于肿瘤下端距肛缘5.1~7cm者,将乙状结肠吻合端与保留外括约肌的皮下部皮肤吻合;方法2用于肿瘤下端距肛缘5cm以下者,将乙状结肠吻合端与会阴部的皮肤吻合。两种术式均能达到肿瘤彻底根治的要求,并能保全肛门。通过临床观察证明肠浆肌片制成的人工内括约肌能长期存活,不会吸收或脱落,亦不会形成瘢痕组织和僵硬的肌管,并有一定的括约功能。人工直肠瓣似一个闸门,能起到阻档粪便的作用。通过临床检测排便功能是比较理想的,收到的临床效果是满意的。
In our hospital from 1987 to 1995 with artificial rectal flap and artificial internal sphincter preserving anus for the treatment of low rectal cancer in 60 cases, its operation is in the sigmoid colon anastomosis more than 3cm, the front wall of the intestinal pleat suture 3cm, made with the colon With a 45 ° artificial oblique flap (that is, artificial rectal flap), and then prepared 8cm long colostomy muscle sheet wrapped around the artificial rectal flap centered on the entire wall. The anastomosis methods are as follows: Method 1 is used for the lower end of the tumor from the anal verge of 5.1~7cm. The anastomosis of the sigmoid colon is matched with the subcutaneous skin of the external sphincter; the method 2 is used for the sigmoid colon anastomosis when the tumor is less than 5cm from the anal margin. In line with the skin of the perineum. Both surgical procedures can achieve the complete cure of the tumor and can preserve the anus. Through clinical observation, it was proved that artificial internal sphincter made from entero-muscle sheet can survive for a long time, it will not absorb or fall off, nor will it form scar tissue and stiff myotubes, and it has certain sphincter function. The artificial rectal valve resembles a gate and can act as a stopper. The clinical detection of defecation function is ideal and the clinical effect received is satisfactory.