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1981～1991年,Mayo(161例)和Cleveland(56例)诊所对117例直肠癌行直肠乙状结肠切除后结肠肛管吻合术。平均随访55(2～141)个月。对术后并发症、肛管功能、癌肿复发及生存率联合评估。 117例直肠癌病人,男:女=2.6,平均年龄59岁(26～80)。Dukes A、B、C、D期分别为21、53、37、6例,中等分化73%,腺癌89%,距肛缘平均6.7cm,64%位于直肠下1/3段。治疗:J型结肠贮袋肛管吻合18例,其余行结肠肛管直接吻合。73例(62%)行临时造口(结肠造口15%,回肠造口48%)。术前放疗13%,术后放疗15%,联合化疗5%。平均远端清除2(0.1～7)cm。Dukes D期中有4例(4/6)肝转移,肝未切除。并发症:术后30日内无死亡,早期发生漏18%,
Between 1981 and 1991, Mayo (161 cases) and Cleveland (56 cases) clinics performed rectal and sigmoid resection of 117 rectal cancers after colonic anal anastomosis. The average follow-up period was 55 (2 to 141) months. A joint assessment of postoperative complications, anal canal function, recurrence of cancer, and survival rate was performed. 117 patients with rectal cancer, male: female = 2.6, mean age 59 years (26 ~ 80). Dukes A, B, C, and D were 21, 53, 37, and 6 cases, respectively, 73% moderately differentiated, 89% adenocarcinoma, 6.7cm away from the anal margin, and 64% located in the lower third of the rectum. Treatment: 18 cases of anal canal anastomosis with J-type colon pouch. The rest of the colon anal canal was directly anastomosed. 73 cases (62%) performed temporary stoma (colostomy 15%, ileostomy 48%). Preoperative radiotherapy was 13%, postoperative radiotherapy was 15%, and combined chemotherapy was 5%. The average distal removal was 2 (0.1 to 7) cm. There were 4 (4/6) hepatic metastases in Dukes D stage without hepatectomy. Complications: No deaths within 30 days after surgery, 18% leakage in early period