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我院自1979年以来,对距肛缘5～7cm的39例低位直肠癌采用了功能性根治,结肠直肠肛门外吻合术。收到满意效果。 1 临床资料 39例中男28例,女11例。年龄最小32岁,最大76岁。术后发生吻合口瘘2例,盆腔感染1例,均治愈出院。术后31例1～3个月排便功能恢复正常,8例日排便3～4次,尚可控制。性功能:男性28例中有3例阳萎,4例年龄70岁以上无性要求。排尿功能:除3例因前列腺肥大有排尿障碍外,余均正常。术后生存5年以上者26例。手术方法:腹部手术基本同Miles术。直肠充分游离至齿线上1～2cm,注意保留乙状结肠边缘动脉弓。在髂总动脉分叉部注意保留下腹神经分支。该分支在髂内动脉外侧骶_2高度与发自S_2～S_4的盆腔内脏神经
In our hospital since 1979, functional radical surgery and colorectal anal external anastomosis have been used for 39 cases of low rectal cancer from 5 to 7 cm away from the anal margin. Received satisfactory results. 1 Clinical data 39 patients were male and 11 female. The youngest is 32 years old and the oldest is 76 years old. Postoperative anastomotic leakage occurred in 2 cases and pelvic infection in 1 case. All patients were cured and discharged. In 31 cases, the defecation function returned to normal in 1 to 3 months, and 8 cases of defecation occurred 3 to 4 times per day, which is still controllable. Sexual function: There were 3 cases of impotence in 28 males and 4 cases of asexual age over 70 years. Urinary function: In addition to 3 cases of urination disorders due to prostatic hypertrophy, the rest were normal. There were 26 patients who survived more than 5 years after surgery. Surgical methods: abdominal surgery with Miles surgery. The rectum was fully freed to 1 to 2 cm on the tooth line, and the sigmoid arterial arch was preserved. At the bifurcation of the common iliac artery, attention was paid to retaining the branches of the inferior ventral nerve. This branch is located in the lateral iliac 骶2 height of the internal iliac artery and pelvic visceral nerves from S_2 to S_4