经肛门括约肌间直肠切除结肠肛管吻合术作为超低位直肠癌保肛术的初步报告

被引：4

作者：

阚永丰

刘军

高志刚

渠浩

郑毅

易秉强

机构：

[1] 首都医科大学附属北京朝阳医院胃肠外科

来源：

中华外科杂志 | 2005年 / 09期

关键词：

直肠肿瘤; 直肠结肠切除术,重建性; 肛门; 直肠;

D O I：

暂无

中图分类号：

R735.37 [];

学科分类号：

100214 ;

摘要：

目的探讨经肛门括约肌间直肠切除结肠肛管吻合术(PIDCA)联合术前后放疗和化疗对超低位直肠癌保肛手术的治疗效果。方法从2002年6月到2004年10月,对19例患者施行该手术。男性11例,女性8例,平均年龄56岁(41～74岁)。肿瘤分期T14例、T210例、T34例、T41例,肿瘤距离肛缘平均4.4cm(3.5～5.0cm)。经肛门在直视下从距离肿瘤下缘2cm全层切断直肠或肛门内括约肌,通过肛门内外括约肌间隙向上方游离直肠并与经腹完成的直肠游离汇合切除直肠及其系膜,经肛门行结肠肛管吻合,全部患者均未行预防性结肠或回肠造口。结果无手术死亡,吻合口瘘2例(10.5%)。随访时间为3～29个月,平均随访16个月,1例盆腔复发,复发率5.3%。术后肛门括约肌功能比较满意。结论对经过选择的距离肛缘≤5cm的超低位直肠癌结合术前后的盆腔放疗和化疗,PIDCA术是保留肛门括约肌功能较理想、安全的术式,有较好根治性治疗效果,术后肛门括约肌功能比较满意。

引用

页码：573 / 575

页数：3

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