全直肠系膜切除术加改良Bacon手术治疗超低位直肠癌的临床研究
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张毅

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Clinical study of combined total mesorectal excision and modified Bacon procedure for treatment of very low rectal cancer
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    摘要:

    摘要:目的 探讨全直肠系膜切除术(TME)加改良Bacon手术治疗超低位直肠癌的手术适应证和手术操作方法。
    方法 对76例确诊为直肠癌的癌灶下缘距肛门缘4~8 cm的患者,采用自制肛门牵开器经腹腔和肛门途径行TME加改良Bacon手术。
    结果 全组手术均成功,无手术死亡,无吻合口瘘,2例发生吻合口狭窄。术后随访76例1~5年,术后3~5个月开始恢复排便自控功能,为3~6次/d; 6个月以后肛门排便功能基本恢复正常,为1~3次/d。其中5例于术后1~2年吻合口区域局部癌复发(6.58%);1,3,5年生存率分别为100%,80.83%和68.37%。
    结论 TME加改良Bacon手术是一种治疗无远处转移的Dukes A~C期超低位直肠癌的安全有效的方法。

    Abstract:

    Abstract:Objective To evaluate the operative indications and technique of combined total mesorectal excision (TME)with modified Bacon procedure for treatment of very low rectal cancer.
    Methods Seventysix cases who was proven very low rectal cancer in which the distance between the anal verge and the lower margin of the tumor was 4-8 cm underwent combined abdominal and trans anal TME and modified Bacon procedure with use of selfmade anal retractor.
    Results There was no operative mortality or anastomotic fistula, and in all cases the operation was successful. The followup was 1-5 years. Local postoperative recurrence developed in 5 cases(6.58%)in 1-2 years, and 2 cases had anastomotic stenosis. The 1,3, and 5year survival rate was 100%,80.83%, and 68.37%, respectively. Defecation was under satisfactory control 3~6 months after operation and restored to normal in 6 months.
    Conclusions Combined TME and modified Bacon procedure is a safe and effective method for treatment of very low rectal cancer of Dukes stages A, B and C cases without distant metastasis.

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张毅,洪光晨,宋培铎.全直肠系膜切除术加改良Bacon手术治疗超低位直肠癌的临床研究[J].中国普通外科杂志,2007,16(9):3-.
DOI:10.7659/j. issn.1005-6947.2007.09.003

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  • 收稿日期:2006-10-23
  • 最后修改日期:2007-06-08
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  • 在线发布日期: 2007-09-25