中国实用外科杂志

中国实用外科杂志

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纵向部分括约肌切除术治疗超低位直肠癌12例分析

夏志秀，丛进春，陈春生   

  1. 中国医科大学附属盛京医院结直肠肿瘤外科，辽宁沈阳110004
  • 发布日期:2012-03-31

  • Published:2012-03-31

摘要：

目的    探讨纵向部分括约肌切除术治疗超低位直肠癌的临床疗效。方法    回顾性分析2004年1月至2008年4月中国医科大学附属盛京医院行纵向部分括约肌切除术治疗超低位直肠癌12例病人的临床资料，采用向量测压来评价其临床疗效。结果    中位随访35.5个月，均未出现局部复发，仅1例在术后24个月出现远处转移并行左半肝切除。向量测压结果显示术后最大静息压和收缩压明显升高，而静息向量容积和收缩向量容积明显降低，不均衡指数在静息状态和收缩状态均显著升高。所有指标随着时间的推移逐渐趋于正常。结论   超低位直肠癌病人采用纵向部分括约肌切除术能够获得足够的根治性和可接受的肛门功能。

关键词: 纵向部分括约肌切除术, 超低位直肠癌, 根治性, 肛门功能

Abstract:

Longitudinal partial sphincter resection for super-low rectal carcinoma: an analysis of 12 cases        XIA Zhi-xiu, CONG Jin-chun, CHEN Chun-sheng. Department of Colorectal Tumor Surgery, Shengjing Hospital of China Medical University, Shenyang110004, China
Corresponding author: CHEN Chun-sheng, E-mail: chenchunsheng @sj-hospital.org
Abstract    Objective    To explore the curative effect of longitudinal partial sphincter resection for super-low rectal carcinoma. Methods    The clinical data of 12 cases of super-low rectal carcinoma performed longitudinal partial sphincter resection between January 2004 and April 2008 at Shengjing Hospital of China Medical University were analyzed retrospectively. Functional results were assessed by vector manometry. Results    There was no postoperative mortality, and no cases developed local recurrence during the median observation period of 35.5 months. One case had distant metastasis at 24 months, and underwent resection of the left liver. Anorectal vector manometry showed significantly increased maximum resting and squeezing anal pressures, and declined maximum resting and squeezing anal volumes. The radial asymmetry index, either during resting status or squeezing status, was significantly higher after operation. But all the indexes trended towards normal over time. Conclusion    Curability and acceptable anal function can be obtained by longitudinal partial sphincter resection for super-low rectal carcinoma.

Key words: longitudinal partial sphincter resection, super-low rectal carcinoma, curability, anal function