摘要
目的评价弧形切割闭合器在低位直肠癌前切除双吻合术中的应用。方法分析比较2006年10月-2011年12月对50例低位直肠癌前切除应用弧形切割闭合器行双吻合术(以下简称双吻合组)与70例低位直肠癌前切除使用荷包钳荷包闭合行单吻合术(以下简称单吻合组)的临床效果。结果双吻合组保肛率为98.0%,手术时间为145～270 min,术中出血量为153～247 ml,吻合口瘘为4.0%,吻合口出血为4%;单吻合组保肛率为82.9%,手术时间为220～350 min、术中出血量为246～354 ml,吻合口瘘为11.4%,吻合口出血为8.6%。双吻合组保肛率、手术时间、术中出血量优于单吻合组;吻合口瘘和吻合口出血并发症两组差异无统计学意义。结论弧形切割闭合器的应用能扩大直肠癌保肛手术,操作简单,缩短手术时间,减少出血量和肠腔内容物溢出对术区的污染,并没有增加术后并发症,值得推广应用。
Objective To evaluate the effect of curved cutter stapler in double anastomosis for the low anterior resection for rectal cancer.Methods From October 2006 to December 2011,the double anastomosis with curved cutter stapler was performed in the low anterior resection for 50 cases of low rectal cancer（double anastomosis group）;while the single anastomosis with single stapling technique and purse-string forceps was performed for 70 cases of low anterior resection（single anastomosis group）.The clinical effects were observed and compared.Results In the double anastomosis group,the anal sphincter preservation rate was 98.0%,the operative time was 145 to 270 minutes,intraoperative blood loss was 153 to 247 ml,rate of anastomotic leakage was 4.0%,anastomotic bleeding was 4%;in the single anastomosis group,sphincter preservation rate was 82.9 %,operative time was 220 to 350 minutes,intraoperative blood loss was 246 to 354 ml of 11.4%,anastomotic leakage,anastomotic bleeding was 8.6%.The double anastomosis group showed a better effect in sphincter preserving rate,operative time and blood loss as compared to the single anastomosis group;anastomotic leakage and anastomotic bleeding and other complications was no difference between the two groups.Conclusion The curved cutter stapler,with a lower rate of postoperative complications,can expand the application of anal sphincter preserving operation,simplify the operation,shorten the operation time,reduce the amount of bleeding and intestinal lumen contents spill on pollution of operation areas.it is worthy of popularization and application.
出处
《中华全科医学》
2012年第7期1018-1020,共3页
Chinese Journal of General Practice
基金
广东省从化市农村和社会发展科技计划项目(从科信农社[2011]生-09)
关键词
双吻合
单吻合
弧形切割闭合器
低位直肠癌
Double anastomosis
Single anastomosis
Curved cutter stapler
Low anterior resection for rectal cancer
