论文部分内容阅读
本文针对中、下段直肠癌,在不影响根治原则的基础上,设法保留或重建肛门功能,避免腹壁造瘘的手术。自1995年8月~2004年10月,共施行直肠癌根治术86例,其中行保肛手术48例。就临床观察,术后肛门功能恢复情况,以低位前切除术最佳,股薄肌移植术若手术成功,功能恢复亦称满意。许多学者曾经将Dixon手术改良演变成其他多种术式如各种拖出式吻合,但吻合器可以完成在直肠、肛管任何位置的吻合,所以结肠拉出术在临床上较少采用。适应证选择应以早中期、病变局限、深度不超过肌层,术中探查无明显区域淋巴结转移的高、中分化腺癌为主。依据病变占居部位,采用不同的手术方式。
This article aims at middle and lower rectal cancer, on the basis of not affecting the principle of cure, trying to retain or rebuild anal function, to avoid abdominal wall fistula surgery. From August 1995 to October 2004, 86 patients underwent radical resection of rectal cancer, of whom 48 underwent sphincter preserving surgery. With regard to clinical observation and postoperative anal function recovery, the best anterior resection was performed. If the operation of the gracilis muscle was successful, the functional recovery was also satisfactory. Many scholars have once improved the Dixon surgery to other multiple surgical procedures such as a variety of pull-out anastomosis, but the stapler can complete the anastomosis at any position of the rectum and anal canal, so the colon pull-out surgery is less commonly used clinically. Indications should be selected in the early and mid-term, lesions, limitations, depth does not exceed the muscle layer, intraoperative exploration of no significant regional lymph node metastasis of high, moderately differentiated adenocarcinoma based. According to the lesion site, use different surgical methods.