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对26例中、下段直肠癌采用前切除术洽疗,肿瘤上方切除范围与腹会阴切除术相同,下方在瘤下3cm处切断肠管及其周围淋巴脂肪组织。手术并发症有腹腔内出血1例,粘连性肠梗阻1例,直肠阴道瘘2例。文中介绍自制带“橡皮帽沿”直肠镜,术中上顶盆底可使直肠残端提升2～3cm,有利于手缝法吻合操作的顺利进行。对肿瘤远端肠管切除范围、手术技术要点、吻合口瘘的防治及术前肿瘤活检的价值进行了讨论。
26 cases of rectal cancer in the middle and lower rectal cancer were treated with anterior resection. The upper resection range of the tumor was the same as abdomino-perineal resection. The lower part of the tumor was cut at 3 cm below the tumor and the surrounding lymphatic adipose tissue was cut. The surgical complications included 1 case of intra-abdominal hemorrhage, 1 case of adhesive intestinal obstruction, and 2 cases of rectal vaginal fistula. The article describes a self-made rectal mirror with a “rubber brim” edge. The top pelvic floor during surgery can lift the rectal stump by 2 to 3 cm, which is conducive to the smooth operation of hand-stitching. The scope of distal tumor resection, surgical techniques, prevention of anastomotic leakage, and the value of preoperative tumor biopsy were discussed.