120例直肠疾病患者经肛门括约肌路径手术的临床疗效

目的探讨经肛门括约肌路径的手术（Mason手术）在直肠外科中的应用。方法回顾分析1990年8月至2005年8月同120例中下段直肠疾病患者施行Mason手术的临床资料。结果全组直肠绒毛状腺瘤61例。其中伴癌变者26例；直肠癌25例；直肠黏膜下结节17例；直肠阴道瘘13例；直肠尿道瘘1例；直肠良性狭窄3例。103例直肠肿物中行直肠部分切除术98例，直肠节段切除术5例。术后伤口感染2例（1．7％），直肠。皮肤瘘4例（3．3％）。肿瘤局部复发3例（2．9％）。全组术后无发生肛门失禁者。确诊直肠癌的51例患者术后存活逾5年者达90．2％。结论Mason手术具有手术径路直达、术野表浅和显露良好的优势。适用于可行局部手术治疗的中下段直肠良、恶性疾病。

Transsphincteric surgery of rectal lesions: a report of 120 cases

Objective To generalize the clinical use of transsphincteric operation (Mason operation)for rectal lesions. Methods Clinical data of 120 patients with middle and lower rectal lesions who underwent Mason operation from Aug. 1990 to Aug. 2005 were analyzed retrospectively. Results There were 61 cases with villous adenoma including 26 with cancerization,25 cases with rectal cancer including 16 cases with early rectal cancer,and 17 with submucosal tumor. Of the 103 patients with rectal tumor,98 underwent partial rectectomy,5 segmental rectectomy. The postoperative complications included incision infection in two cases(1.6%),fistula in 4 cases(3.3%). Three patients(3.0%) had postoperative local recurrence. 90.2%of the rectal cancer patients(46/51) survived more than five years after Mason operation. Conclusion Mason operation is satisfactory because of good exposure and simple access to the rectum,which is suitable for those lesions that could be locally resected on the mid and low rectum.