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目的探索弧形切割缝合器在低位直肠癌(距肛缘4～7cm)保肛手术中的应用价值。方法47例低位直肠癌患者,按TME治疗原则行保肛手术,术中应用弧形切割缝合器行直肠-肛管间切割、闭合。术后随访6～18个月,回顾性分析其根治性、术后排便功能、手术并发症及局部复发率。结果本组无手术中死亡,术后病理学检查无切端癌残留,无大便失禁,吻合口漏2例,吻合口狭窄4例,局部复发1例,腹壁切口感染2例,盆腔感染1例,术后肿瘤局部复发1例。术后排便功能基本正常,控便能力满意。术后性功能3个月内基本恢复正常。排尿功能恢复时间7～20d(平均9d)。结论在低位直肠癌中应用弧形切割缝合器行保肛手术安全、有效,能获得较好的根治与保留肛门功能效应。
Objective To explore the value of curved cutting stapler in anorectal surgery for low rectal cancer (4 ~ 7cm from the anal verge). Methods Forty - seven patients with low rectal cancer underwent TME therapy. The patients underwent anal sphincter preservation surgery. The patients underwent arc - recto - suturing and recto - anal canal incision and closure. The patients were followed up for 6 to 18 months. The curative effect, postoperative defecation function, operative complications and local recurrence rate were retrospectively analyzed. Results There were no operative deaths in this group. No postoperative residual incision, no incontinence, no anastomosis, 2 anastomotic leakage, 4 anastomotic stenosis, 1 local recurrence, 2 abdominal incision infection, 1 pelvic infection, Local recurrence of tumor in 1 case. Postoperative defecation function is normal, control ability is satisfactory. Postoperative sexual function returned to normal within 3 months. Urine function recovery time 7 ~ 20d (average 9d). Conclusions In low rectal cancer, arc-shaped incision suture device is safe and effective for anal sphincter preservation. It can obtain better radical cure and retain anal functional effect.