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目的探讨中下段直肠癌保留肛门括约肌功能手术的安全性及效果。方法对24例中下段直肠癌患者实施拖出式Welch法超低位切除术,即肿瘤切除后使直肠远端外翻,近端结肠经外翻的直肠拖出,于肛门外行结肠直肠一期吻合,待吻合确实后还纳入肛门内。结果肿瘤局部复发3例(12.5%)Dukes,B期1例(4.2%),C期2例(8.4%)。术后6个月排便次数、控便机能正常及良好者21例(87.5%),较差者3例(12.5%)。5年生存率62.5%(15/24)。结论保留肛门括约肌的拖出式吻合术,在确保癌根治的情况下,选择合适的病例,可获得较高的生存率及生活质量。
Objective To investigate the safety and effect of preserving anal sphincter function in the lower and middle rectal cancer. Methods Twenty-four patients with rectal cancer were treated by pull-out Welch’s ultra-low resection. The tumors were excised and the distal rectum everted and the proximal colon everted. The anorectal colostomy was performed in the first stage , To be anastomosed indeed into the anus. Results Tumor recurrence in 3 patients (12.5%) Dukes, B in 1 case (4.2%), C in 2 cases (8.4%). There were 21 cases (87.5%) with normal bowel function and good control in 3 months (12.5%) after 6 months. 5-year survival rate of 62.5% (15/24). Conclusion Retaining anus anal sphincter traction anastomosis, to ensure that the case of cancer, the appropriate choice of cases, access to higher survival rates and quality of life.