中华普外科手术学杂志（电子版）
中華普外科手術學雜誌（電子版）
중화보외과수술학잡지（전자판）
CHINESE JOURNAL OF OPERATIVE PROCEDURES OF GENERAL SURGERY(ELECTRONIC VERSION)
2009年
2期
498-502
,共5页
直肠肿瘤%吻合术%外科%结直肠外科手术%保肛手术
直腸腫瘤%吻閤術%外科%結直腸外科手術%保肛手術
직장종류%문합술%외과%결직장외과수술%보항수술
Rectal neoplasms%Anastomosis,surgical%Colorectal surgery%Sphincter-reserving operation DST
目的 探讨结直肠一层缝合吻合法和双吻合器吻合法在低位直肠癌保肛手术中的应用效果.方法 回顾性分析1998年1月至2007年1月间136例用一层缝合法进行吻合,210例用双吻合技术行保留肛门的低位直肠癌的临床资料.结果 一层缝合法组无吻合口漏及狭窄,双吻合组吻合口漏发生率为1.4%,吻合口狭窄0.9%,均经保守治疗治愈.344例获得1～9年随防.一层吻合法组和双吻合器吻合组局部复发率分别为2.9%和3.3%,肝转移组3.7%和5.7%:肺转移1.4%和2.4%.一层缝合法组术后1、3、5年生存率分别为100%、82.5%、76.5%.双吻合组术后1、3、5年生存率分别为100%、81.4%、75.2%.结论 双吻合技术具有操作简便易行、安全,术后并发症少、术后生活质量好,而一层吻合法价格低廉,在低位结直肠保肛术中有应用价值,值得临床推广.
目的 探討結直腸一層縫閤吻閤法和雙吻閤器吻閤法在低位直腸癌保肛手術中的應用效果.方法 迴顧性分析1998年1月至2007年1月間136例用一層縫閤法進行吻閤,210例用雙吻閤技術行保留肛門的低位直腸癌的臨床資料.結果 一層縫閤法組無吻閤口漏及狹窄,雙吻閤組吻閤口漏髮生率為1.4%,吻閤口狹窄0.9%,均經保守治療治愈.344例穫得1～9年隨防.一層吻閤法組和雙吻閤器吻閤組跼部複髮率分彆為2.9%和3.3%,肝轉移組3.7%和5.7%:肺轉移1.4%和2.4%.一層縫閤法組術後1、3、5年生存率分彆為100%、82.5%、76.5%.雙吻閤組術後1、3、5年生存率分彆為100%、81.4%、75.2%.結論 雙吻閤技術具有操作簡便易行、安全,術後併髮癥少、術後生活質量好,而一層吻閤法價格低廉,在低位結直腸保肛術中有應用價值,值得臨床推廣.
목적 탐토결직장일층봉합문합법화쌍문합기문합법재저위직장암보항수술중적응용효과.방법 회고성분석1998년1월지2007년1월간136례용일층봉합법진행문합,210례용쌍문합기술행보류항문적저위직장암적림상자료.결과 일층봉합법조무문합구루급협착,쌍문합조문합구루발생솔위1.4%,문합구협착0.9%,균경보수치료치유.344례획득1～9년수방.일층문합법조화쌍문합기문합조국부복발솔분별위2.9%화3.3%,간전이조3.7%화5.7%:폐전이1.4%화2.4%.일층봉합법조술후1、3、5년생존솔분별위100%、82.5%、76.5%.쌍문합조술후1、3、5년생존솔분별위100%、81.4%、75.2%.결론 쌍문합기술구유조작간편역행、안전,술후병발증소、술후생활질량호,이일층문합법개격저렴,재저위결직장보항술중유응용개치,치득림상추엄.
Objective To evaluate the value of the one-layer manual suture and double stapling technique (DST) in sphincter-reserving operation for low rectal neoplasm. Methods The clinical data of 136 patients with low rectal cancer who underwent one-layer manual suture and 210 patients with low rectal cancer who underwent DST in sphincter-reserving operation from January 1998 to January 2007 were reviewed retrospectively. Results No stomal leak and anastomotic strictune occurred in the one-layer manual suture group. The local recurrence rate of the tumor was 2.9% , the incidence of liver metastasis was 3.7%, the incidence of pulmonary metastasis was 1.4% in the one-layer manual suture group . The postoperative one-year survival rate, the three-year survival rate , the five-year survival rate were 100%,82.5%,76.5% respectively in the one-layer manual suture group. The incidence rate of stomal leak was 1.4%, the incidence of anastomotic stricture was 0.9% , the local recurrence rate was 3.3%, the incidence of liver metastasis was 5.73%, the incidence of pulmonary metastasis was 2.4% in the DST group . 334 patients were followed up from one year to nine years. The postoperative one-year survival rate, the three-year survival rate, and the five-year survival rate were 100%, 81.4%, 75.2% respectively in the DST group. Conclusions DST is safe and convenient with few complications and quality of life after operation. One-layer manual suture technique is cheap and applicable in sphincter-reserving operation for low rectal neoplasm.
