论文部分内容阅读
目的探讨乙状结肠系膜分型对直肠癌手术的重要影响。方法 2005年9月—2010年9月收治直肠癌(肿瘤据肛门5.0cm以上)患者500例,观察乙状结肠的系膜分型与直肠癌手术方式、术后吻合口愈合情况。结果 360例患者为乙状结肠左侧腹膜呈点状融合即Ⅰ型,系膜血管边缘弓基本没有变异,血供好,全部行Dixons术,术后吻合口漏6例;92例患者乙状结肠系膜与左侧腹膜呈线状融合即Ⅱ型,系膜血管弓有变异,系膜血供较差,行Hartmann术6例,行Dixons术86例,术后吻合漏12例;48例患者乙状结肠左侧及右侧系膜与后腹膜均呈线状融合即Ⅲ型,系膜血管弓有明显变异,系膜血供最差,行Hartmann手术16例,行Dixons术32例,术后吻合漏8例。结论掌握好乙状结肠系膜分型,术者能提前预知手术方式,降低手术手术风险,减少手术创伤。
Objective To investigate the important effect of sigmoid mesangial classification on rectal cancer surgery. Methods From September 2005 to September 2010, 500 patients with rectal cancer (tumor with anus over 5.0 cm) were enrolled in this study. The mesangial types of sigmoid colon and rectal cancer were observed. The anastomotic healing was observed. Results 360 patients were dot-like fusion of the left peritoneum of the sigmoid colon, that is, type Ⅰ. The edge of the mesangial margin of the mesangial was basically unchanged. The blood supply was good. All the patients underwent Dixons operation and anastomotic leak was found in 6 patients. The sigmoid mesangium The left peritoneal linear fusion that type Ⅱ, mesangial vascular bow variability, poor blood supply to the mesangium, line Hartmann operation in 6 cases, line Dixons operation 86 cases, 12 cases of postoperative anastomotic leakage; 48 cases of sigmoid colon left And the right mesentery and retroperitoneal were linear fusion that type Ⅲ, mesangial vascular bow significant variability, the mesentery blood supply was the worst, 16 cases underwent Hartmann operation, line Dixons operation in 32 cases, 8 cases of postoperative anastomotic leakage . Conclusion To master the sigmoid mesangial classification, the surgeon can predict the operation mode in advance, reduce the surgical operation risk and reduce the surgical trauma.