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1993年1月至1995年4月应用双吻合器进行直肠前切除端端吻合术(Dixon术)113例,其中属低位吻合术(即吻合口位于腹膜返折平面以下者)88例,占77.88%;内81例系低位直肠癌(距肛缘7cm以内),占同期116例低位直肠癌的69.83%。全组无手术死亡;术后发生吻合口漏5例(占4.4%),吻合口狭窄12例(占10.6%);术后局部复发5例,其中2例为吻合口复发,3例为盆腔复发,总的局部复发率4.4%。本组资料显示双吻合器明显提高了低位直肠癌时的保肛手术成功率,局部复发未见增加,说明选作保肛手术是合适的。术后吻合口漏和吻合口狭窄是双吻合器手术中的主要并发症,本文讨论了并发症的防治问题。
From January 1993 to April 1995, there were 113 patients undergoing anterior rectal anastomosis (Dixon) using a double stapler, 88 of which were low anastomosis (ie, the anastomosis was located below the peritoneal plane), accounting for 77.88. %; 81 cases were low rectal cancer (within 7cm from the anal verge), accounting for 69.83% of 116 cases of low rectal cancer in the same period. There were no operative deaths in the whole group; postoperative anastomotic leakage occurred in 5 cases (4.4%), anastomotic stenosis in 12 cases (10.6%); local recurrence occurred in 5 cases, including 2 cases of anastomotic recurrence and 3 cases of pelvic cavity For recurrence, the overall local recurrence rate was 4.4%. The data in this group showed that the double stapling device significantly improved the success rate of sphincter preserving surgery in low rectal cancer, and local recurrence did not increase, indicating that it was appropriate to choose sphincter preserving surgery. Postoperative anastomotic leakage and anastomotic stenosis are the major complications in double stapler surgery. This article discusses the prevention and treatment of complications.