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1889年首次报道用电凝破坏癌肿,在过去25年中作者曾用电凝治疗直肠癌190例,其中114例已观察5年以上,本文重点加以分析.资料和方法所有病人均因浸润性直肠腺癌手术,不包括绒毛状腺瘤和在息肉基础上发生的癌.当时肿瘤根治的标准是肿瘤距肛缘不足7.5cm,肿瘤浸润直肠直径不到一半,活动与周围结构不固定.尽量少选Dukes“C”级病变.手术前夜和当天早晨做快速灌肠,在全麻下手术,取截石位,另加局麻包括0.490 bipuvocaine 30ml,肾上腺素1∶200000,透明质酸酶300混浊度单位,可使局部松弛,选用合适的直肠镜.偶需做侧括约肌切开.使用Cameron电凝装置装配有双极凝固电流,用5m
In 1889, it was reported for the first time that electrocoagulation was used to destroy cancer. In the past 25 years, the author used electrocoagulation to treat 190 cases of rectal cancer, of which 114 cases have been observed for more than 5 years. This article focuses on the analysis. Materials and methods All patients are invasive Rectal adenocarcinoma surgery, excluding villous adenomas and cancers that occur on the basis of polyps. The standard of tumor eradication at that time was that the tumor was less than 7.5cm away from the anal margin, and the tumor infiltrated the rectum less than half in diameter. The activity and surrounding structures were not fixed. Less choice for Dukes“C” grade lesions. Fast enema on the eve of the operation and the morning of the day, surgery under general anesthesia, taking a lithotomy position, plus local anesthesia including 0.490 bipuvocaine 30 ml, epinephrine 1:200,000, hyaluronidase 300 turbidity unit, can make local relaxation, use a suitable proctoscope. Even need to do sphincterotomy. Use Cameron coagulation device equipped with bipolar coagulation current, with 5m