论文部分内容阅读
目的探讨经肛门括约肌手术在中低位直肠肿瘤局部切除术中的作用和疗效。方法对1990年3月至2007年3月采用经肛门括约肌手术的97例中低位直肠肿瘤病例进行回顾性分析。结果全组行直肠部分切除术91例,直肠节段切除术6例。术后并发伤口感染5例(5.2%),直肠皮肤瘘4例(4.2%)。术后病理结果为:直肠绒毛状腺瘤35例,直肠癌50例,直肠类癌等12例。直肠癌中 Tis 期17例,T1期21例,T2期7例,T3期2例,T4期3例。术后平均随访6.4年(2个月～16年)。术后肿瘤局部复发3例(6.2%)。术后3年和5年生存率分别为93.7%和87.5%。本组无手术死亡,无术后肛门失禁。结论经肛门括约肌直肠肿瘤局部切除术具有手术创伤小、风险低和易于保留肛门等优点,适用于中低位直肠肿瘤的治疗。
Objective To investigate the effect and efficacy of anal sphincter surgery in the local excision of low and middle rectal tumors. Methods From March 1990 to March 2007, 97 cases of low and middle rectal tumors treated with anal sphincter were retrospectively analyzed. Results All the patients underwent partial rectal resection in 91 cases and rectal resection in 6 cases. Postoperative wound infection in 5 cases (5.2%), 4 cases of rectal skin fistula (4.2%). Postoperative pathological results were: 35 cases of rectal villous adenoma, 50 cases of rectal cancer, rectal carcinoid in 12 cases. Tis in 17 cases of rectal cancer, T1 in 21 cases, T2 in 7 cases, T3 in 2 cases, T4 in 3 cases. After an average follow-up of 6.4 years (2 months to 16 years). Postoperative local tumor recurrence in 3 cases (6.2%). The 3-year and 5-year survival rates were 93.7% and 87.5% respectively. This group no surgical death, no incontinence after surgery. Conclusion The transrectal resection of anal sphincter has the advantages of less operation trauma, low risk and easy to retain the anus, which is suitable for the treatment of low and middle rectal tumors.