深部弧形切割吻合器在低位和超低位直肠癌手术的应用价值

目的 探讨深部弧形切割吻合器在低位/超低位直肠癌保肛手术中的应用价值.方法 2005年10月至2006年3月,对52例术前确诊为低位/超低位直肠癌的患者使用弧形切割吻合器施行直肠远端切割与闭合,配合圆形吻合器完成规范化直肠癌全直肠系膜切除术或微创化小切口全直肠系膜切除术低位/超低位/结肛吻合术.结果 患者均顺利完成吻合,切缘均无癌残留.术后未发生近期并发症.术后随访6-12个月无局部复发病例.结论 使用深部弧形切割吻合器具有更快捷的切割闭合程序、术中污染少、远切缘更安全、拓宽了深部闭合范围、适用于极低位直肠癌的远端钉合等优点,并可作为微创化/小切口直肠癌根治术的重要辅助工具.

Applicafion of curved cutter stapler in anterior resection of ultra-low rectal cancer

Objective To research curved cutter stapler in anterior resection of ultra-low rectal cancer.Methods From Oct 2005 to March 2006，there were 52 patients diagnosed as low/ultra-low rectal cancer，with distance between dentate line 1～3cm were 18 cases，3～5 cln 27 cases and 5～7 cm were 7 cases.The age was 28～79(average 66.3)year.The body massindex(BMI)was 18-26(average 23.4). In the low anterior resection 2 cases， ultra-low anterior resection and colo-anal anastomosis were 50 cases.The distal ends of rectum were cut and close by curved cutting stapler,some with reverse double-stapling technique(DST)27 cases.Results There were 27 cases in standard total mesorectal excision, and others were in mini-incision total nlesorectal excision(TME) with average incision length 8.2 cm.All patients finished anastomosis successfully,without cancer residual in incisal edges.There were no recent complications.Follow up in 6～12 months，there were no local reemxent.Conclusion Application of curved cutter stapler contributed to faster and easier progression of cutting and stapling.It was good for less pollution， safer distal-end incisal edge， wider used and so on，being important instrument for mini-invasive or mini-incision rectal radical excision.