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目的探讨低位直肠癌实施保肛手术的可行性。方法回顾性分析 12 4例低位直肠癌行保肛扩大根治术的临床资料。结果术后上方淋巴结转移率 5 6.4% ,侧方淋巴结转移率 19.3 % ,下方无淋巴结转移。随访 2～ 5年 ,吻合口复发 3例 ,盆腔复发 1例 ,局部复发率3 .2 %。因肝转移死亡 6例 ,脑转移死亡 1例。结论影响低位直肠癌保肛术后生存率的主因是血行转移 ,而不是局部复发。低位直肠癌实施全直肠系膜切除及扩大淋巴结清扫 ,在保证根治前提下 ,合理选择手术适应症 ,积极实施保肛手术是可行的
Objective To investigate the feasibility of anus-preserving surgery in low rectal cancer. Methods A retrospective analysis of 12 4 cases of rectal cancer underwent extended radical mastectomy clinical data. Results The postoperative lymph node metastasis rate of 5 6.4%, lateral lymph node metastasis rate of 19.3%, the bottom of no lymph node metastasis. Follow-up 2 to 5 years, anastomotic recurrence in 3 cases, pelvic recurrence in 1 case, the local recurrence rate was 3.2%. 6 died of liver metastasis and 1 died of brain metastasis. Conclusion The main reason affecting the survival rate of the anus-preserving surgery in patients with low rectal cancer is blood metastasis, not local recurrence. Low rectal cancer implementation of total mesorectal excision and expansion of lymph node dissection, under the premise of ensuring radical cure, a reasonable choice of surgical indications, and the active implementation of anal sphincter is feasible