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目的评价弧形切割闭合器在低位直肠癌前切除双吻合术中的应用。方法分析比较2006年10月-2011年12月对50例低位直肠癌前切除应用弧形切割闭合器行双吻合术(以下简称双吻合组)与70例低位直肠癌前切除使用荷包钳荷包闭合行单吻合术(以下简称单吻合组)的临床效果。结果双吻合组保肛率为98.0%,手术时间为145～270 min,术中出血量为153～247 ml,吻合口瘘为4.0%,吻合口出血为4%;单吻合组保肛率为82.9%,手术时间为220～350 min、术中出血量为246～354 ml,吻合口瘘为11.4%,吻合口出血为8.6%。双吻合组保肛率、手术时间、术中出血量优于单吻合组;吻合口瘘和吻合口出血并发症两组差异无统计学意义。结论弧形切割闭合器的应用能扩大直肠癌保肛手术,操作简单,缩短手术时间,减少出血量和肠腔内容物溢出对术区的污染,并没有增加术后并发症,值得推广应用。
Objective To evaluate the application of curved cutting closure in anterior anastomosis of low rectal cancer. Methods Analysis and comparison of 50 cases of low rectal cancer anterior resection with arc cutting closure double anastomosis (hereinafter referred to as double anastomosis group) and 70 cases of low rectal cancer anterior resection with purse-string purse closure from October 2006 to December 2011 Single line anastomosis (hereinafter referred to as single anastomosis group) clinical effect. Results The anastomosis rate was 98.0% in the double anastomosis group, the operation time was 145-270 min, the intraoperative blood loss was 153-247 ml, the anastomotic leakage was 4.0%, the anastomotic bleeding was 4%, and the anastomosis rate of the single anastomosis group was 82.9%, operation time was 220-350 min, intraoperative blood loss was 246-354 ml, anastomotic leakage was 11.4%, and anastomotic bleeding was 8.6%. The anastomosis rate, operation time, and intraoperative blood loss of the double anastomosis group were better than those of the single anastomosis group; there was no significant difference in the anastomotic leakage and anastomotic bleeding complication between the two groups. Conclusion The application of curved cutting and closing device can expand rectal cancer sphincter preserving operation, simplify operation, shorten operation time, reduce blood loss and the contamination of intestinal cavity contents on the operation area, and does not increase postoperative complications. It is worthy of popularization and application.