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目的 评价在妇科肿瘤盆腔根治性手术中采用吻合器进行直肠结肠吻合的有效性及其并发症。方法 回顾性分析 2 0 0 1年 3月～ 2 0 0 4年 2月我院 11例妇科肿瘤患者的资料 ,所有患者均接受晚期卵巢癌的首次细胞减灭术或其他妇科盆腔复发灶再次切除术 ,术中将盆腔腹膜内原发灶和转移灶连同部分直肠结肠整块切除 ,同时用吻合器将直肠结肠端端吻合。结果 11例患者的平均年龄为 5 4 .7岁 ,其中Ⅲ～Ⅳ期上皮性卵巢癌 9例 ,宫颈癌和宫体癌各 1例。 8例卵巢癌患者在首次细胞减灭术中 ,连同原发卵巢肿瘤、盆腔转移灶及部分直肠结肠完整地切除 ,并行低位直肠结肠吻合术 ,其中 7例 (87.5 % )术后残留灶 <1cm。其他 3例复发性盆腔肿瘤 ,切除复发灶和部分直肠结肠 ,无可见肿瘤残存。除 1例膀胱排尿困难外 ,未发生吻合口漏 ,无围手术期死亡。平均随访 19.3个月 ,除 1例复发性卵巢癌患者术后 6个月死于肝转移外 ,其余 10例均无瘤生存。结论 在晚期妇科肿瘤手术中 ,使用吻合器行低位直肠结肠吻合有利于盆腔肿瘤的完整切除 ,并发症极少
Objective To evaluate the effectiveness and complications of stapler for colorectal anastomosis in pelvic radical surgery of gynecologic cancer. Methods The data of 11 cases of gynecologic oncology in our hospital from March 2001 to February 2004 were retrospectively analyzed. All patients underwent the first cytoreductive surgery of ovarian cancer of the late stage or other recurrent resections of pelvic recurrence Intraoperative intraoperative pelvic peritoneal primary tumor and metastasis together with part of the rectum colon resection, at the same time with the stapler colon anastomosis. Results The average age of the 11 patients was 54.7 years, of which 9 cases were epithelial ovarian cancer of stage Ⅲ ~ Ⅳ, and 1 case of cervical cancer and uterine body cancer. 8 cases of ovarian cancer patients in the first cytoreductive surgery, along with primary ovarian tumors, pelvic metastases and partial resection of the colon and complete rectal colostomy, and parallel low rectal colon anastomosis, of which 7 cases (87.5%) residual lesions <1cm . The other 3 cases of recurrent pelvic tumors, resection foci and part of the rectum colon, no visible tumor remains. In addition to a case of bladder dysuria, anastomotic leakage did not occur, no perioperative deaths. With an average follow-up of 19.3 months, the remaining 10 patients had no tumor-free survival except for one case of recurrent ovarian cancer who died of liver metastasis 6 months after surgery. Conclusion In the treatment of advanced gynecological tumors, the use of anastomosis device for colorectal anastomosis is conducive to the complete resection of pelvic tumors with minimal complications