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目的探讨全直肠系膜切除术(total mesorectal excision,TME)结合双吻合器(DST)治疗低位直肠癌的效果及临床价值。方法对我院60例低位直肠癌患者采用TME和DST联合治疗的方法,观察治疗后的排便功能及疗效。结果所有患者手术均顺利,无吻合口瘘和狭窄,切割环均完整,无手术闭合失败及手术死亡。随访时间6个月～5年,局部复发率为3.33%。排便控制功能:优55例(91.7%),良5例(8.3%),差0例。排便感觉功能:优43例(71.7%),良17例(28.3%),差0例。结论TME和DST联用可为低位直肠癌保肛手术的首选术式。疗效满意,并发症少,提高了患者的生存质量,值得临床推广。
Objective To investigate the effect and clinical value of total mesorectal excision (TME) combined with double stapling (DST) in the treatment of low rectal cancer. Methods 60 cases of low rectal cancer patients in our hospital with TME and DST combined treatment methods to observe the defecation function and efficacy. Results All the patients were operated smoothly without anastomotic fistula and stenosis. All the cutting rings were intact, with no surgical closure failure and surgical death. Follow-up time of 6 months to 5 years, the local recurrence rate was 3.33%. Defecation control function: excellent in 55 cases (91.7%), good in 5 cases (8.3%), poor in 0 cases. Defecation sensory function: excellent in 43 cases (71.7%), good in 17 cases (28.3%), poor in 0 cases. Conclusion The combination of TME and DST may be the first choice for anorectal surgery for low rectal cancer. Satisfactory efficacy, fewer complications, improve the quality of life of patients, it is worth clinical promotion.