摘要
目的探讨国产圆形吻合器在中低位直肠癌保肛术治疗中的可行性和安全性。方法对107例中低位直肠癌经腹肛门根治性切除行国产圆形吻合器吻合保肛术进行回顾性临床分析。107例患者中男62例，女45例。年龄27～99岁，平均为57．9岁。肿瘤下缘距齿状线5～8cm。病理诊断直肠腺癌103例，其中高分化者37例，中分化者55例，低分化者11例。腺瘤癌变4例。Dukes分期：A期29例，B期57例，C期17例，D期4例。结果术后随访率为85．9％（92／107），中位随访时间为46个月。术后发生吻合口瘘4例（3．7％），吻合口狭窄3例（2．8％），术后12～24周时排便功能基本恢复到正常。术后局部复发率为6．5％（6／92），肝转移率为13．0％（12／92），术后总体的5年生存率为66．6％（32／48）。结论国产圆形吻合器在低位直肠癌保肛术的应用，其性能和安全行与进口吻合器无大的区别，更实用于经济条件较差的患者。
Objective To assess the feasibility and safety of domestic spherical stapler in the treatment of middle and low colorectal cancer by anus-preservation. Methods We retrospectively analyzed 107 cases of anus-preservation anastomosed with China-made spherical stapler. Of these patients 62 were male and 45 female, aged 27 -99 years. The low margins of tumors were between 5-8 cm to the anal verge. Histopathological examination revealed adenocarcinoma in 103 patients： 37 well-differentiated, 55 moderately differentiated, 11 poorly differentiated, and 4 adenomas with canceration. Duke stage classification showed 29 patients in stage A, 57 in stage B, 17 in stage C, and 4 in stage D. Results 85.9% （92/107） patients were followed up for a median of 46 months. Postoperative complications included stoma leak in 4（3.7% ） patiens and stoma stenosis in 3 （2.8%）. All patients recovered normal defecating function during 12 - 24 weeks after operation. Local recurrence rate was 6.5% （6/92）. The rate of hepatic metastasis was 13.0% （12/92） and the 5-year survival rate was 66.6%. Conclusions The safety and efficiency of China-made spherical stapler is similar to imported stapler in anus-preservation operation for low rectal cancer.
出处
《中华普外科手术学杂志（电子版）》
2009年第4期60-62,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
