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目的探讨超低位直肠癌前切除术中应用小口径吻合器的安全性及优势。方法回顾性分析2006年6月至2009年6月期间我院普外科收治的60例超低位直肠癌患者的临床资料,均按TME原则行直肠癌双吻合器法前切除术。分别使用33mm口径吻合器和29mm口径吻合器进行吻合,每组各30例,对比分析2组患者术中、术后及预后情况。结果 33mm口径吻合器组术中单纯吻合时间为(9.0±3.3)min,29mm口径吻合器组为(6.0±2.6)min,2组比较差异有统计学意义(P=0.022 5);术中因损伤致吻合不良而需行吻合口修补者33mm口径吻合器组6例,29mm口径吻合器组2例,2组比较差异有统计学意义(P=0.030 1);2组的总手术时间,术后吻合口漏、狭窄、出血、复发、大便失禁的发生情况及住院时间差异均无统计学意义(P>0.05)。结论在超低位直肠癌前切除术中,使用29mm口径吻合器可以降低手术难度,缩短术中吻合口的吻合时间,但不增加术后吻合口狭窄及其他并发症的发生。
Objective To investigate the safety and advantages of using a small caliber stapler in anterior resection of ultra-low rectal cancer. Methods The clinical data of 60 patients with ultralow rectal cancer admitted to our hospital from June 2006 to June 2009 were analyzed retrospectively according to the TME principle. The diameter of the anastomosis was 33 mm and the diameter of the 29 mm anastomosis was used for anastomosis. Each group had 30 cases. The operation, postoperative and prognosis of the two groups were compared and analyzed. Results The mean time of anastomosis was (9.0 ± 3.3) min in the 33mm caliber stapler group and (6.0 ± 2.6) min in the 29mm caliber stapler group, respectively. There was significant difference between the two groups (P = 0.022 5) There were significant differences between the two groups (P = 0.030 1). The total operation time and operation of the two groups were significantly different from those of the other two groups After anastomotic leakage, stenosis, bleeding, recurrence, fecal incontinence and hospital stay were not significantly different (P> 0.05). Conclusion In the ultra-low rectal cancer resection, the use of 29mm caliber stapler can reduce the difficulty of operation and shorten the time of anastomotic anastomosis, but does not increase the incidence of anastomotic stenosis and other complications.