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[目的]探讨直肠全系膜切除(TME)下行双吻合器(DST)在低位直肠癌保肛手术中的临床应用效果。[方法]回顾性分析2009年1月～2011年1月某院收治的72例直肠癌患者,均应用全直肠系膜切除同时行双吻合器低位直肠前切除保肛手术的相关临床资料。[结果]全组无手术闭合失败及手术死亡。本组中吻合口距齿状线≤2cm以内者8例,2～4cm30例,≥4cm以上34例。本组72例术后病理检查切除部位癌细胞阳性2例(2.8%)。本组术后发生吻合口狭窄1例(1.4%),伤口液化5例(6.9%),直肠阴道瘘1例(1.4%),吻合口出血3例(2.3%),术后出现吻合口漏4例(5.6%)。本组患者平均随访1.4年。术后1年后,72例患者其中局部复发5例(6.9%),无肛门失禁发生。[结论]全直肠系膜切除联合双吻合器的应用符合肛门肛门功能,操作简单、经济,是治疗低位直肠癌的有效方法。
[Objective] To explore the clinical effect of double-stapler rectal total mesotomy (TME) double-stapler (DST) in the anorectal surgery of low rectal cancer. [Methods] A retrospective analysis of 72 patients with rectal cancer treated in a hospital from January 2009 to January 2011 was performed with total mesorectal excision and double stapling simultaneously. [Results] The whole group had no surgical closure failure and surgical death. The anastomotic group in this group from the dentate line ≤ 2cm less than 8 cases, 2 ~ 4cm30 cases, ≥ 4cm above 34 cases. The group of 72 cases of postoperative pathological resection of cancer cells in 2 cases (2.8%). One case (1.4%) had anastomotic stenosis, five cases (6.9%) had liquefaction wound, one case had rectovaginal fistula (1.4%) and three cases had anastomotic bleeding (2.3%). Anastomotic leakage 4 cases (5.6%). The average follow-up of this group of patients 1.4 years. One year after the operation, 72 patients were locally recurred in 5 cases (6.9%), and no anal incontinence occurred. [Conclusion] The application of total mesorectal excision combined with double stapler conforms to the anal anus function, which is simple and economical. It is an effective method for the treatment of low rectal cancer.