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目的探讨经济、实用、安全的直肠癌低位保肛手术方法。方法对245例中低位直肠癌患者按全直肠系膜切除术(TME)要求切除直肠,荷包缝合钳封闭直肠残端,管型直肠吻合器行低位保肛术。结果低位前切除106例,超低位前切除117例,结肠肛管吻合术22例。本组切缘均无肿瘤残留。术后出现吻合口瘘10例(4.1%),均经横结肠造瘘后痊愈;尿潴留16例(6.5%);手术死亡1例(0.4%)。结论用荷包缝合钳代替直线型吻合器行直肠癌低位保肛术安全、简便、经济。
Objective To explore economical, practical and safe rectal cancer surgery with low sphincter preservation. Methods A total of 245 patients with low rectal cancer were treated with total mesorectal excision (TME). The rectum was removed, the purse-stringed suture forceps were used to seal the rectal stump, and the tube-type rectal stapler was used for low-grade sphincter preservation. Results 106 patients underwent low anterior resection, 117 patients underwent ultralow anterior resection, and 22 patients underwent colon anal canal anastomosis. There was no tumor residue in the margin of this group. Anastomotic fistula occurred in 10 cases (4.1%) after surgery, and was cured by transverse colon fistulization; urinary retention was 16 cases (6.5%); surgical death occurred in 1 case (0.4%). [Conclusion] The use of purse-string suture forceps instead of linear stapling device is safe, simple and economical for low rectal cancer-preserving anus.