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目的 总结开展经骶经肛管途径行直肠中下段肿瘤局部切除的治疗体会。方法 对 2例腺癌、2例绒毛状腺瘤恶变、1例类癌及 2例绒毛状腺瘤患者 ,采取经骶经肛管途径手术入路 ,行包括肿瘤在内的直肠局部切除。结果 治愈 6例 ,并发直肠粪漏 1例 ,局部肿瘤复发再行Miles手术 1例。全部患者术后肛门括约肌功能良好。结论 本方法微创且能保证直肠肿瘤的局部有效切除 ,保持肛门括约肌功能 ,对中下段直肠良性肿瘤及早期恶性病变尤为有效。
Objective To summarize the experience of local resection of middle and lower rectal tumors through the sacral canal. Methods Two cases of adenocarcinoma, two cases of malignant villous adenoma, one case of carcinoid and two cases of villous adenoma were treated with sacral and anal canal approach and partial resection of rectum including tumor. Results 6 cases were cured, one case was complicated with rectal leakage, and one case was treated with Miles recurrence after local tumor recurrence. All patients with anal sphincter function well. Conclusions This method is minimally invasive and can ensure the local effective resection of rectal tumors and maintain anal sphincter function. It is especially effective in the middle and lower rectal benign tumors and early malignant lesions.