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1978年10月至1985年12月,作者等施行52例直肠癌腹会阴联合根治术。不缝合盆底腹膜,让小肠和网膜下坠到骶前。为使大网膜坠入骶前,后40例行游离和延长左半大网膜,此法填塞满意;即指大网膜体积肥厚,游离延长后能填塞残腔80％以上者23例,22例会阴创口Ⅰ期愈合。全组随访率为90.2％,5年生存率为57.1％(4/7,失访1例以死亡计)。此外,在其中16例加行双侧髂内动脉结扎,术时止血满意,6例术中不输血,9例仅输血200ml,1例止血效果不良,输血800ml。此法不仅节约输血而且提高切除率和手术的彻底性,无不良反应,值得推荐。
From October 1978 to December 1985, the authors performed 52 cases of rectal cancer combined with abdominal perineum. Do not suture the pelvic peritoneum so that the small intestine and the omentum fall to the anterior ridge. In order to make the omentum fall into the anterior iliac crest, the posterior 40 cases were dissociated and extended the left half of the large omentum. This method was satisfactory; that means the omental volume was hypertrophic, and 23 cases were able to fill more than 80% of the residual cavity after being extended. Twenty-two cases of perineal wounds healed by first intention. The follow-up rate of the whole group was 90.2%, and the 5-year survival rate was 57.1% (4/7; one case was lost to death). In addition, in which 16 patients were treated with bilateral internal iliac artery ligation, the bleeding was satisfactory during the operation, 6 patients did not receive blood transfusion, 9 patients only received blood transfusion of 200 ml, 1 patient had poor hemostasis, and blood transfusion was 800 ml. This method not only saves blood transfusion but also improves the resection rate and the thoroughness of the operation. No adverse reactions are recommended.