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目的探讨超低位直肠癌经直肠拖出采用单吻合器技术行保肛手术的可行性。方法对近8年来收治的31例超低位直肠癌(肿瘤下缘距肛缘≤5cm)患者,采用全直肠系膜切除、直肠拖出、双荷包、单吻合器技术行结肠肛管吻合术。结果31例患者均顺利完成直肠癌保肛根治切除手术,且均未行预防性回肠或结肠造口。术后发生吻合口瘘5例(16.1%),吻合口狭窄2例(6.5%),局部复发2例(6.5%),无大便失禁及围手术期死亡。5年的生存率为78.6%(11/14)。结论对于超低位直肠癌保肛手术,采用直肠拖出单吻合器技术一期手术,安全可行,且费用相对较低。
Objective To investigate the feasibility of anorectal surgery with single stapling technique for rectal drainage of ultra-low rectal cancer. Methods Thirty-one patients with ultralow rectal cancer who had been treated in the last 8 years (the lower edge of the tumor was ≤5cm away from the anal verge) underwent total anorectal anastomosis with total mesorectal excision, rectal pull-out, double wallets and single stapling technique. Results All 31 patients underwent radical ananectomy for colorectal cancer, and none of the patients underwent prophylactic ileum or colostomy. There were 5 cases (16.1%) of anastomotic fistula, 2 cases of anastomotic stenosis (6.5%) and 2 cases (6.5%) of local recurrence after operation. There was no fecal incontinence and perioperative death. The 5-year survival rate was 78.6% (11/14). Conclusions For the anorectal surgery of ultra-low rectal cancer, it is safe and feasible to use the technique of rectal pull-out single stapler surgery, and the cost is relatively low.