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目的:总结低位直肠癌行全系膜切除(TME)双吻合技术(DST)保肛的临床应用经验。方法:回顾性分析我院外科2002年2月至2005年6月38例低位直肠癌行TME和DST保肛的临床资料。结果:全组病例均顺利行TME和DST,无手术死亡病例,两切端病理均阴性,无吻合口瘘和狭窄。平均手术时间130min,术中平均出血量150mL,术后尿潴留1例,全组病例均得到随访,随访时间6～40个月,局部复发2例(5.2%),死亡1例,系术后11个月糖尿病继发肺部感染,大便次数增多18例,其中>4次/d8例,均保守治疗3～6个月恢复正常。结论:低位直肠癌行TME和DST治疗既能达到根治降低局部复发率又能保留肛门功能,提高生活质量。是操作简便、安全和有效的手术方式。
Objective: To summarize the experience of clinical application of anal sphincter preservation in total mesorectal excision (TME) double anastomosis (DST) in patients with low rectal cancer. Methods: A retrospective analysis of surgical data from February 2002 to June 2005 in 38 patients with low rectal cancer TME and DST anal preservation of clinical data. Results: All cases were successfully treated with TME and DST, no case of surgical death, both ends of the pathology were negative, no anastomotic fistula and stenosis. The average operation time was 130 min. The mean intraoperative blood loss was 150 mL. One patient had postoperative urinary retention. All patients were followed up for 6 to 40 months. Local recurrence occurred in 2 patients (5.2%) and 1 patient died after operation Eleven months later secondary to pulmonary infection of diabetes, stool frequency increased in 18 cases, of which> 4 times / d8 cases were conservative treatment of 3 to 6 months returned to normal. Conclusion: The treatment of low rectal cancer with TME and DST can both achieve radical reduction of local recurrence rate, retain anal function and improve quality of life. Is easy to operate, safe and effective surgical methods.