CAJ | 학술논문

目的:分析超低位直肠癌Miles根治术同时行股薄肌Ⅰ期原位肛门再造临床效果.方法:50例超低位直肠癌患者Miles根治术同时行Ⅰ期原位肛门重建,重建内括约肌、直肠瓣、肛管直肠角及外括约肌.结果:50例患者手术均顺利,手术时间90~130 min,平均110 min,出血量120~180 ml,平均150 ml.手术后患者恢复排便感觉及控制排便时间为6~60 d,平均33 d,均无夜间静息性排便,术后3个月无大便失禁,排便功能总优良率达93.82%.直肠角静息压、内外括约肌平均压差及钡剂在直肠平均存留时间基本接近正常.结论:超低位直肠癌Miles根治术股薄肌Ⅰ期肛门重建既完成了直肠癌根治,又解决了排便问题,患者生存质量得到明显提高,是一种安全有效的手术方法.
목적:분석초저위직장암Miles근치술동시행고박기Ⅰ기원위항문재조림상효과.방법:50례초저위직장암환자Miles근치술동시행Ⅰ기원위항문중건,중건내괄약기、직장판、항관직장각급외괄약기.결과:50례환자수술균순리,수술시간90~130 min,평균110 min,출혈량120~180 ml,평균150 ml.수술후환자회복배편감각급공제배편시간위6~60 d,평균33 d,균무야간정식성배편,술후3개월무대편실금,배편공능총우량솔체93.82%.직장각정식압、내외괄약기평균압차급패제재직장평균존류시간기본접근정상.결론:초저위직장암Miles근치술고박기Ⅰ기항문중건기완성료직장암근치,우해결료배편문제,환자생존질량득도명현제고,시일충안전유효적수술방법.
Objective:To analyze the clinical effects of Miles’operation for ultra-low rectal cancer patients with radical cure at the same time to reconstruct by gracilis muscle in situ at phaseⅠ. Method:50 patients with ultra-low rectal cancer were operated on Miles’operation at the same time to reconstruct anus in situ at PhaseⅠ,reconstructed internal sphincter and rectal valve and anorectal angle and external sphincter. Result:50 patients were operated successfully,and the average time of operation was 110 min(90-130 min),the average bleeding was about 100 ml(120-180 ml). The patients took for 6 to 60 days,with the average of 33 days,recovered their senses and control of defecation without resting defecation during night and without gatism 3 months after the operation. The ratio of fine defecation’s function was 93.82%. Rectal angle resting pressure,internal and external sphincter pressure and an average of barium in the rectum closed to the normal average lifetime. Conclusion:Miles’operation for ultra-low rectal cancer patients with radical cure at the same time to reconstruct by gracilis muscle in situ at phaseⅠnot only completes the colorectal cancer,but also solves the defecation problem. The quality of life in patients is conspicuously improved and it is a safe and effective surgical method.