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目的 :评价荷包环扎式结直肠吻合保肛术治疗低位直肠癌的价值。方法 :对低位直肠癌采用荷包环扎结直肠吻合保肛术治疗 2 3例 (A组 ) ,采用Miles手术治疗 2 6例 (B组 )。结果 :A组术后 1、3年生存率分别为 10 0 % (2 3/ 2 3) ,95 7% (2 2 / 2 3) ,术后无局部复发病例 ;排便功能优 16例 (6 9 6 % ) ,良 7例 (30 4 % )。B组术后 1、3年生存率分别为 10 0 % (2 6 / 2 6 ) ,96 2 % (2 5 /2 6 ) ,术后局部复发率 3 8% (1/ 2 6 )。两组术后 1、3年生存率 ,局部复发率经统计检验 ,均无显著差异 (P值均 >0 0 5 )。术后并发症 :A组无吻合口瘘及吻合口狭窄发生 ,盆腔感染 1例。B组 :切口感染 1例 ,人工肛门狭窄 1例。结论 :采用螺纹支架管荷包环扎结直肠吻合保肛术治疗低位直肠癌既能达到根治目的 ,又有保留肛门的良好排便功能 ,且并发症少 ,操作简便易行 ,不用特殊器械 ,值得推广应用
Objective: To evaluate the value of pouch-tied colorectal anastomosis anal sphincter for the treatment of low rectal cancer. Methods: Twenty-three cases (group A) underwent rectal ring anastomosis and anal sphincter preservation surgery for low rectal cancer and 26 cases (group B) underwent Miles operation. Results: The 1-year and 3-year survival rates of group A were 10 0% (2 3/2 3), 95 7% (2 2/2 3) respectively. There was no local recurrence after operation in group A, 9 6%), good in 7 cases (30 4%). The 1-year and 3-year survival rates of group B were 100% (26/26) and 962% (25/26) respectively, and the postoperative local recurrence rate was 38% (1/26). There was no significant difference in the 1-year and 3-year survival rates and local recurrence rates between the two groups (P> 0.05). Postoperative complications: A group of anastomotic leakage and anastomotic stenosis, pelvic infection in 1 case. Group B: incision infection in 1 case, artificial anal stenosis in 1 case. Conclusion: It is worth to popularize that rectal anastomosis and anal sphincter preservation with anal sphincter preservation can both achieve the goal of radical treatment and maintain the good defecation function of the anus with fewer complications. It is easy to operate and requires no special instruments application