中国实用外科杂志

中国实用外科杂志 ›› 2007, Vol. 27 ›› Issue (06): 1-437.

• 论著 •    

经腹结肠肛管吻合术治疗低位直肠癌

潘义生，万远廉，刘玉村，汪欣，吴涛   

  1. 北京大学第一医院普外科，北京100034
  • 收稿日期:2007-01-26 修回日期:2007-02-20 出版日期:2007-06-22 发布日期:2007-06-22
  • 通讯作者: 万远廉

Transabdominal coloanal anastomosis for low rectal cancer located between 4 and 6cm away from the anal verge

<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((PAN YiSheng[Author]) AND 1[Journal]) AND year[Order])" target="_blank">PAN YiSheng</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((WAN YuanLian[Author]) AND 1[Journal]) AND year[Order])" target="_blank">WAN YuanLian</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((LIU YuCun[Author]) AND 1[Journal]) AND year[Order])" target="_blank">LIU YuCun</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((et al.[Author]) AND 1[Journal]) AND year[Order])" target="_blank">et al.</a>   

  1. Department of Surgery,Peking University First Hospital,Beijing 100034，China
  • Received:2007-01-26 Revised:2007-02-20 Online:2007-06-22 Published:2007-06-22
  • Contact: WAN Yuan-lian

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摘要：

目的:探讨经腹结肠肛管吻合术治疗低位直肠癌的临床应用价值。方法:回顾性分析 2001年11月至2005年12月，北京大学第一医院普外科收治的36例距肛缘4～6cm的低位直肠癌采用双吻合技术行直肠及部分外科肛管全层切除（部分内括约肌切除），经腹结肠肛管吻合术的资料。结果:吻合口距肛缘平均2.5cm。中位随访时间23个月，术后远处转移4例，无局部复发者。3年总存活率100%，无瘤存活率84.6%。术后1年，随访28例病人，根据Williams分级标准，肛门控便功能Ⅰ级（完全自制）23例，Ⅱ级（排气失禁）2例，Ⅲ级（偶尔漏稀便）3例。结论:经腹结肠肛管吻合术是治疗距肛缘4～6cm低位直肠癌的较理想保肛术式；切除部分内括约肌对肛门的远期功能无明显影响。

关键词: 低位直肠癌, 经腹结肠肛管吻合术

Abstract:

Objective:To investigate the effect of transabdominal coloanal anastomosis on the treatment of low rectal cancer located between 4 and 6cm away from the anal verge. Methods:From November 2001 to December 2005,36 patients with low rectal cancer between 4 and 6cm away from the anal verge underwent partial internal anal sphincter resection and transabdominal coloanal anastomosis with double stapling technique. Results:The coloanal anastomosis was about 2.5cm above the anal verge.The median followup was 23 months. Distant metastasis occurred in 4 patients and no local recurrence was confirmed.Total 3year survival rate was 100% and tumorfree 3year survival rate was 84.6%.According to Williams’s classification of continence,among 28 patients after 1 year surgery,23 patients were in GradeⅠ(Perfect),2 patients in Grade Ⅱ (Incontinent of flatus),3 patients in Grade Ⅲ (Occasional minor soiling). Conclusion:Transabdominal coloanal anastomosis is an optimal sphinctersaving procedure for low rectal cancer located between 4 and 6cm away from the anal verge.Partial internal anal sphincter resection does not compromise the longterm anal function.

Key words: low rectal cancer, transabdominal coloanal anastomosis