摘要
目的探讨腹腔镜及开腹全直肠系膜切除术(TME)联合内括约肌切除术(ISR)治疗低位直肠癌的术式、疗效、并发症及恢复肛门功能的治疗经验。方法回顾性分析2007年3月至2009年7月实施开腹或腹腔镜TME联合ISR治疗6例低位直肠癌患者的临床资料及随访资料,总结手术结果、并发症、术后辅助治疗、肿瘤预后、大便次数及肛门功能Kirwan分级随时间的变化情况。结果 6例手术均达到根治性切除,除1例肛门狭窄外无其他手术并发症发生,5例行术后放化疗。6例患者最长随访时间48个月,未发现肿瘤复发及转移,每天大便次数均随时间进展逐渐减少,至术后1年降至5～8次/d,肛门功能Kirwan分级随时间进展逐渐下降。结论 TME联合ISR对具适应证的低位直肠癌疗效确定,腹腔镜手术更具优势,扩肛等术后治疗措施有助于防止并发症的发生,有利于肛门功能的恢复。
Objective To evaluate the operative methods, therapeutic results, complications of the combination of total mesoreetal excision （ TME ） and intersphineterie resection （ ISR ） as treatment to low rectal cancer and the experiences of the efforts to regain anal functions after the operation. Methods Study the clinic and follow up data of 6 cases that received TME combined with ISR through laparoscopie operations or laparotomy between March 2007 and July 2009 retrospectively. Summarize the operation results, complications, post-operation therapies, prognosis and the variety of defecation frequency and Kirwan scales along with time. Results All the 6 cases achieved radical resection,no complications occurred except anal straitness in 1 case, 5 cases received post-operation chemotherapy or/and radiotherapy. No cancer relapse or metastasis occurred in following procedure as long to 48 months. Defecation frequency reduced along with time and reached 5 ~8 times per day 1 year after the operation. Kirwan scales reduced along with time too. Conclusions Combination of TME and ISR could achieve confirmed therapeutic results as treatment to low rectal cancer with indications. Laparoscopic operation has more predominances. Post-operation therapies such as anus dilation are helpful to prevent complications and regain anal functions.
出处
《中华腔镜外科杂志（电子版）》
2010年第5期31-34,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
