中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
8期
614-616
,共3页
李世拥%梁振家%苑树俊%陈纲%白雪%左富义%于波%陈光%魏晓军%杜峻峰%徐一石
李世擁%樑振傢%苑樹俊%陳綱%白雪%左富義%于波%陳光%魏曉軍%杜峻峰%徐一石
리세옹%량진가%원수준%진강%백설%좌부의%우파%진광%위효군%두준봉%서일석
直肠肿瘤,超低位%肛门内括约肌切除术%套入式吻合%治疗效果
直腸腫瘤,超低位%肛門內括約肌切除術%套入式吻閤%治療效果
직장종류,초저위%항문내괄약기절제술%투입식문합%치료효과
Rectal neoplasms,ultra-low%Intersphincteric resection%Telescopic anastomosis%Treatment outcomes
目的 探讨经腹经肛门行肛门内括约肌切除套入式吻合保肛术治疗超低位直肠癌的安全性和临床效果。方法 回顾性分析北京军区北京总医院收治的61例超低位直肠癌(距肛缘4～5 cm)患者接受经腹肛门内括约肌切除套入式吻合保肛术治疗的临床资料。结果 61例患者中男34例，女27例;平均年龄56.7岁。癌灶下缘距肛缘4 cm者21例，5 cm者40例;病理诊断直肠腺癌55例，其中高分化者24例，中分化者29例，低分化者2例；腺瘤癌变6例；TNM分期：T1N0M0为36例，T2N0M0为23例，T3N11M0为2例。术后1～3个月排粪自控能力明显改善，6～12个月时肛门排粪控制功能基本恢复正常。术后发生吻合口瘘2例(3.3％)，吻合口狭窄3例(4.9％)。54例(88.5％)患者接受了术后随访，中位随访时间为6.2年。术后复发3例(5.6％)，5年生存率73.5％。结论 肛门内括约肌切除套入式吻合保肛术治疗超低位直肠癌是一种安全、有效的保肛术式。
目的 探討經腹經肛門行肛門內括約肌切除套入式吻閤保肛術治療超低位直腸癌的安全性和臨床效果。方法 迴顧性分析北京軍區北京總醫院收治的61例超低位直腸癌(距肛緣4～5 cm)患者接受經腹肛門內括約肌切除套入式吻閤保肛術治療的臨床資料。結果 61例患者中男34例，女27例;平均年齡56.7歲。癌竈下緣距肛緣4 cm者21例，5 cm者40例;病理診斷直腸腺癌55例，其中高分化者24例，中分化者29例，低分化者2例；腺瘤癌變6例；TNM分期：T1N0M0為36例，T2N0M0為23例，T3N11M0為2例。術後1～3箇月排糞自控能力明顯改善，6～12箇月時肛門排糞控製功能基本恢複正常。術後髮生吻閤口瘺2例(3.3％)，吻閤口狹窄3例(4.9％)。54例(88.5％)患者接受瞭術後隨訪，中位隨訪時間為6.2年。術後複髮3例(5.6％)，5年生存率73.5％。結論 肛門內括約肌切除套入式吻閤保肛術治療超低位直腸癌是一種安全、有效的保肛術式。
목적 탐토경복경항문행항문내괄약기절제투입식문합보항술치료초저위직장암적안전성화림상효과。방법 회고성분석북경군구북경총의원수치적61례초저위직장암(거항연4～5 cm)환자접수경복항문내괄약기절제투입식문합보항술치료적림상자료。결과 61례환자중남34례，녀27례;평균년령56.7세。암조하연거항연4 cm자21례，5 cm자40례;병리진단직장선암55례，기중고분화자24례，중분화자29례，저분화자2례；선류암변6례；TNM분기：T1N0M0위36례，T2N0M0위23례，T3N11M0위2례。술후1～3개월배분자공능력명현개선，6～12개월시항문배분공제공능기본회복정상。술후발생문합구루2례(3.3％)，문합구협착3례(4.9％)。54례(88.5％)환자접수료술후수방，중위수방시간위6.2년。술후복발3례(5.6％)，5년생존솔73.5％。결론 항문내괄약기절제투입식문합보항술치료초저위직장암시일충안전、유효적보항술식。
Objective To investigate the efficacy and safety of sphincter-preserving procedure with transabdominal intersphincteric resection for ultra-low rectal cancer. Methods Clinical data of 61 cases with ultra-low rectal cancer (distance from anal verge ranged from 4-5 cm) were analyzed retrospectively. The patients underwent sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis. Results There were 34 males and 27 females. The mean age was 56.7 years. The inferior border of the tumor was 4 cm above the anal verge in 21 cases, and 5 cm in 40 cases. There 55 patients with rectal adenocarcinoma in this cohort. The tumor was welldifferentiated in 24 cases, moderately-differentiated in 29 cases, and poorly-differentiated in 2 cases. There were 6 cases with malignant adenoma. The TNM staging was T1N0M0 in 36 cases, T2N0M0 in 23, and T3N1M0 in 2. The ability to control defecation significantly improved in 1-3 months postoperatively, and returned to normal in 6-12 months. Two patients developed anastomotic leak (3.3％), and 3 anastomotic stenosis (4.9％) postoperatively. Fifty-four patients(88.5％) had follow-up.The median follow-up time was 6.2 years. The local recurrence rate was 5.6％, and the 5-year-survival rate was 73.5％. Conclusion Sphincter-preserving procedure with intersphincteric resection and telescopic anastomosis is a safe and effective procedure for ultra-low rectal cancer.
