中低位直肠癌行套入式吻合保肛术402例临床研究
중저위직장암행투입식문합보항술402례림상연구
Anus-preserving rectectomy using telescopic anastomosis for middle and lower rectal cancer, report of 402 cases
  • 万方数据
    中华普通外科杂志 중화보통외과잡지
    CHINESE JOURNAL OF GENERAL SURGERY
    2011年 7期 537-539 ,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%徐一石%杜峻峰%崔伟

    리세옹%량진가%원수준%진강%백설%좌부의%우파%진광%위효군%서일석%두준봉%최위

    直肠肿瘤%直肠结肠切除术,重建性%治疗,临床研究性 直腸腫瘤%直腸結腸切除術,重建性%治療,臨床研究性
    직장종류%직장결장절제술,중건성%치료,림상연구성
    Rectal neoplasms%Proctocolectomy,restorative%Therapies,investigational
    目的 探讨中低位直肠癌根治套入式吻合保肛术的临床疗效.方法 对中低位直肠癌经腹肛门根治性切除行套入式吻合保肛术402例进行回顾性分析.402例中男241例,女161例.年龄21～99岁,平均55.7岁.肿瘤下缘距肛缘6～12 cm.TNM分期:Ⅰ期123例,Ⅱ期244例,Ⅲ期31例,Ⅳ期4例.结果 402例术后随访率为85.8%(345/402),中位随访时间为6.1年.术后发生吻合口瘘17例(4.2%),吻合口狭窄11例(2.7%),术后12～24周时排便功能基本恢复正常.术后局部复发率为6.3%(22/345),肝转移率为13.6%(47/345).肺转移率为2.6%(9/345).术后5年生存率为68.7%.结论 中低位直肠癌行套入式吻合保肛术式,能保留良好的排便功能,未增加局部复发率,提高患者生活质量.
    목적 탐토중저위직장암근치투입식문합보항술적림상료효.방법 대중저위직장암경복항문근치성절제행투입식문합보항술402례진행회고성분석.402례중남241례,녀161례.년령21～99세,평균55.7세.종류하연거항연6～12 cm.TNM분기:Ⅰ기123례,Ⅱ기244례,Ⅲ기31례,Ⅳ기4례.결과 402례술후수방솔위85.8%(345/402),중위수방시간위6.1년.술후발생문합구루17례(4.2%),문합구협착11례(2.7%),술후12～24주시배편공능기본회복정상.술후국부복발솔위6.3%(22/345),간전이솔위13.6%(47/345).폐전이솔위2.6%(9/345).술후5년생존솔위68.7%.결론 중저위직장암행투입식문합보항술식,능보류량호적배편공능,미증가국부복발솔,제고환자생활질량.
    Objective To study the clinical efficacy of anus-preserving rectectomy by using telescopic anastomosis of colon and rectal mucosa for the middle and lower rectal cancer. Methods A retrospective analysis was carried out in 402 cases with middle and lower rectal cancer undergoing telescopic anastomosis for anus-preserving procedure, including 241 males and 161 females, age ranging from 21 to 99 years, averaging at 55. 7 years. The distal margins of the tumors were within 6 - 9 cm to anal verge. According to TNM staging, there were 123 cases in Stage Ⅰ , 244 cases in Stage Ⅱ , 31 cases in Stage Ⅲ,and 4 cases in Stage Ⅳ. Results 345(345/402, 85. 8% ) cases were followed up, the median time of the follow-up was 6. 1 years. Postoperative complications included 17(4.2%) cases of stomal leakage, 11(2.7% ) cases of stomal stenosis. All patients recovered normal defecating function 12-24 weeks post operation. Local recurrence rate was 6. 3% (22/345). Hepatic and lung metastasis was 13. 6% (47/345) and 2. 6% (9/345)respectively. The five year survival rate was 68. 7% (112/163). Conclusions Anuspreserving rectectomy by using telescopic anastomosis is safe and effective procedure to treat middle and lower rectal cancer, with the preservation of anal function and without the increasing rate of local recurrence.
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