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直肠前切除术(Dixon手术)适用于肿瘤下缘距肛门10cm以上的直肠癌,该术式能消除病人因人工肛门带来的不便。近年作者收治了24例此手术后的病人,发现术后有顽固性便秘的并发症,现分析如下。 临床资料 24例病人中男19例,女5例;年龄19—65岁。癌瘤下缘距肛门7cm者2例;8cm者1例;10cm者11例;12cm者6例;13cm者4例。病检结果腺癌19例;粘液腺癌4例;未分化癌1例。根据改良的Dukes分期,B_1期6例;B_2期11例;C_1期3例;C_2期4例。全部病人术后乙状结肠镜检时发现吻合口无狭窄,个别病人肠腔稍感扩大。便秘情况均需缓泻药治疗和长期维持。
Anterior resection of the rectum (Dixon surgery) is suitable for rectal cancer with an anus more than 10 cm from the lower edge of the tumor. This procedure can eliminate the inconvenience caused by artificial anus. In recent years, the author has treated 24 patients after this operation and found that there are complications of intractable constipation after surgery. The analysis is as follows. Clinical data of 24 patients were 19 males and 5 females; aged 19-65 years old. There were 2 cases of 7cm from the anus of the lower edge of the tumor, 1 case of 8cm, 11 cases of 10cm, 6 cases of 12cm, and 4 cases of 13cm. The results of the examination showed 19 cases of adenocarcinoma, 4 cases of mucinous adenocarcinoma, and 1 case of undifferentiated carcinoma. According to the modified Dukes staging, 6 patients had B1 phase; 11 patients had B2 phase; 3 patients had C_1 phase; 4 patients had C_2 phase. All patients underwent sigmoidoscopy without anastomotic stenosis after surgery, and individual patients had a slightly enlarged intestine cavity. Constipation requires laxatives and long-term maintenance.