直肠拖出双吻合器超低位直肠癌保肛术：附46例报告

目的：评价以直肠拖出和双吻合器技术实施超低位直肠癌保肛手术的疗效。方法：1997年12月—2005年12月利用直肠拖出和双吻合器保肛技术，对46例超低位直肠癌患者行癌肿切除术。肿瘤下缘距肛缘4～7 cm，平均5.5 cm。Dukes分期：A期26例，B期16例，C期4例。结果：46例均成功地保留了肛门和大便控制功能。术后发生吻合口瘘1例（2.2％），吻合口狭窄4例（8.7％）。全组平均随访54个月，其中有2例（4.3％）局部复发。5年生存率为81.3％;无发生排尿功能障碍者;82.4%的男性患者和83.3％女性患者术后性功能良好。结论：直肠拖出双吻合器保肛术是安全可行的，为超低位直肠癌患者提供了新的保肛术式选择。

The pull-through and double stapling technique for sphincter preservation operation in super-low rectal carcinoma :a report of 46 cases

Abstract:Objective：To evaluate the effect of pull-through and double stapling technique for sphincter preservation operation in super-low rectal carcinoma. Methods：The resection through pull-through and double stapling technique for sphincter preservation approach was performed on 46 patients with super-low rectal carcinoma from December 1997 to December 2005. The distance between the anal verge and the lower margin of the tumor was 4～ 7 cm（averaged 5.5 cm），including 26 patients in Dukes A stage，16 Dukes B and 4 Dukes C.Results：Fecal continences were preserved successfully in all patients．Only one got anastomosis leak（2.2％）after operation，and 4 cases had anastomotic narrowing（8.7％）within 1 year.At a median follow-up of 54 months，two patients had local recurrences（4.3％）. The 5 year survival rate was 81.3％. There was no urinary dysfunction in this series.The successful rates of sexual function after surgery were respectively as follows:man 82.4% and woman 83.3%. Conclusions：Pull-through and double stapling technique for sphinceter preservation operation was feasible and safe ，provide a original operative style for super-low rectal carcinoma.