全直肠系膜切除术在直肠癌治疗中的作用

• 作 者: 张定国 熊国田 曾文良 杨国 冯茂辉
• 机 构: 湖北省红安县人民医院外三科,湖北省红安县人民医院外三科,湖北省红安县人民医院外三科,武汉大学中南医院,武汉大学中南医院,
• 出 处: 临床外科杂志
• 发表日期: 2006年10期
• 关键词: 直肠癌 结直肠肿瘤 局部复发率 直肠系膜 保肛手术 并发症 术后吻合口 癌巢 术后并发症 双吻合器技术

目的探讨直肠癌全直肠系膜切除术(TME)的临床应用价值。方法对65例中下段直肠癌行TME,分析术后局部复发率、术后并发症、直肠系膜肿瘤残留情况。结果65例直肠癌局部复发率为7.7%(5/65),术后吻合口漏的发生率为6.2%(4/65),5例术后短期内有泌尿生殖功能障碍,无骶前大出血,术后病检报告系膜内有癌巢存在的有35例(54%)。结论TME是治疗中下段直肠癌必须遵循的原则,能明显降低局部复发率及术后并发症,提高保肛手术率。

Objective To investigate the clinical value of total mesorectal excision (TME) for rectal cancer. Methods Sixty-five patients with rectal cancer in the middle and lower segments underwent TME. The local recurrence rate, postoperative complications and residual mesorectal cancer were analyzed. Results The local recurrence rate was 7.7% (5/65) in 65 cases of rectal cancer, and the incidence of anastomotic leakage was 6.2% (4/65) in 5 cases. There were 5 cases of genitourinary dysfunction in short term after operation, There were 35 cases (54%) of patients with cancer nests in the mesothelium after the pathological examination. Conclusion TME is the principle that must be followed in the treatment of lower rectal cancer, can significantly reduce the local recurrence rate and postoperative complications, and improve the rate of sphincter preserving surgery.