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目的:探讨低位直肠癌全直肠系膜切除术应用吻合器的适应证及术后效果。方法:回顾性分析89例应用吻合器全直肠系膜切除术治疗的低位直肠癌患者临床资料。结果:肿瘤下切缘距离为2 cm者31例,3 cm者36例,4 cm者22例。89例均应用吻合器完成吻合手术,吻合口距齿线≤2 cm者42例,距齿线>2~3 cm者38例,>3~4 cm者9例;术后发生吻合口瘘2例(2.25%),吻合口不同程度狭窄19例(21.3%);术后2个月内排便次数(4.1±5.2)次/d,2~3个月排便次数(2.5±3.2)次/d,3个月后趋于正常。3 a局部复发率8.99%,5 a生存率62.9%。结论:在确保肿瘤根治前提下,应用吻合器全直肠系膜切除术可有效降低术后并发症,增加保肛率。
Objective: To investigate the indications and postoperative effects of stapler for mesorectal excision of low rectal cancer. Methods: The clinical data of 89 patients with low rectal cancer who underwent total mesorectal excision with stapler were retrospectively analyzed. Results: There were 31 cases with tumor margin of 2 cm, 36 cases with 3 cm, and 22 cases with 4 cm. All of the 89 cases were performed anastomosis with anastomat, 42 cases of anastomotic stoma were less than 2 cm, 38 cases were from 2 to 3 cm, 9 cases were> 3 to 4 cm, and anastomotic fistula 2 (2.25%) and 19 cases (21.3%) with different degrees of anastomosis. The number of defecation (4.1 ± 5.2) / d in 2 months after operation and 2.5 ± 3.2 , 3 months later tended to be normal. 3 a local recurrence rate of 8.99%, 5 a survival rate of 62.9%. Conclusion: Under the premise of ensuring tumor radical, the use of stapler mesorectal excision can effectively reduce postoperative complications and increase the rate of anal sphincter preservation.