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目的:探讨经肛管括约肌间径路行超低位直肠癌根治术的安全性及临床疗效。方法:回顾性分析2004-08-2007-08在武汉协和医院接受经肛管括约肌间径路手术治疗的30例超低位直肠癌患者的临床资料;选取同期经腹-会阴联合途径行超低位直肠癌根治术且临床病理资料相匹配的30例患者作为对照组。结果:与对照组相比,经肛管括约肌间径路术式术中出血量减少、手术时间及术后ICU治疗时间缩短(均为P<0.05),术后住院治疗时间差异无统计学意义;术后18个月时,30例患者肛管直肠测压各项指标均趋于正常。两组患者并发症发生率分别为6.7%(2/30)和10.0%(3/30),5年总体累积生存率分别为58.6%和53.3%,差异均无统计学意义。结论:经肛管内外括约肌间切除术治疗超低位直肠癌安全性高、根治效果与对照组相当、预后良好,可显著改善患者术后生活质量。
Objective: To investigate the safety and clinical efficacy of transanal sphincteroplasty in the treatment of ultralow rectal cancer. Methods: The clinical data of 30 patients with ultra-low rectal cancer treated by anal sphincterotomy in Wuhan Union Hospital from August 2004 to July 2007 were retrospectively analyzed. Ultra-low rectal cancer Thirty patients with radical surgery and matched clinicopathological data served as control group. Results: Compared with the control group, intraoperative anal sphincter reduction of intraoperative blood loss, operation time and postoperative ICU treatment time were shorter (both P <0.05), postoperative hospitalization time was no significant difference; At 18 months after operation, all the indexes of anorectal manometry in 30 patients tended to be normal. The complication rates of the two groups were 6.7% (2/30) and 10.0% (3/30) respectively, and the overall 5-year cumulative survival rates were 58.6% and 53.3% respectively, with no significant difference. Conclusion: Surgical resection of the internal and external anal sphincter resection for ultra-low rectal cancer is safe and the curative effect is comparable with that of the control group. The prognosis is good and the postoperative quality of life can be significantly improved.