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目的探讨低位直肠癌的最佳治疗方法。方法对2005年7月—2010年6月间收治的低位直肠癌行保肛术的146例患者进行回顾性分析。结果术后1周内吻合口瘘11例,发生率为7.53%,6例经保守治疗后痊愈,5例二次手术行横结肠造瘘,4例手术后顺利恢复,1例急诊二次手术后出现多脏器功能衰竭、DIC而死亡。保肛手术3年内局部复发率为5.51%。结论低位直肠癌保肛手术只要把握适应证,可作为手术首选。严格掌握保肛手术指征、合理选择患者、规范手术操作是低位直肠癌保肛根治手术成功的关键。
Objective To explore the best treatment of low rectal cancer. Methods A retrospective analysis was performed on 146 patients who underwent anal sphincter preservation surgery for low rectal cancer admitted between July 2005 and June 2010. Results In the first week after operation, anastomotic fistula was found in 11 cases, with a rate of 7.53%. Six cases were cured after conservative treatment. Five cases underwent transverse operation with secondary colostomy. Four cases recovered smoothly after operation, Multiple organ failure occurs, DIC and death. Anorectal surgery within 3 years local recurrence rate was 5.51%. Conclusion Low rectal cancer anal sphincter surgery as long as the indications, can be used as surgery preferred. Strict control of anal sphincter indications, a reasonable choice of patients, regulate the operation of low rectal cancer is the key to the success of the anorectal surgery.