摘要
目的：探讨经骶直肠肿瘤切除术的适应证及疗效。方法：回顾分析32例直肠良、恶性肿瘤行经骶切除术的临床资料。结果：32例病人,男19例,女13例,平均年龄（62.3±3.7）岁。肿瘤距肛缘4~8 cm,直径1.5~3.5 cm。25例病人行肿瘤局部切除,肠壁间断缝合,7例病人行直肠节段切除端端吻合。手术顺利,术后病理诊断为绒毛状腺瘤16例,绒毛状腺瘤恶变5例,管状腺瘤7例,管状腺瘤恶变1例,腺癌3例。9例恶性肿瘤切缘阴性。3例直肠腺癌病人术后予以放、化疗。术后1例发生吻合口瘘,行结肠造瘘转流手术后治愈,无排便失禁;术后随访6个月至5年,均未发生局部复发和转移。结论：在严格掌握适应证的前提下,经骶直肠肿瘤切除术治疗直肠肿瘤可获得理想效果。
Objective To study the indication and effect of transsacral excision of rectal tumors. Methods Thirty-two cases with benign and malignant rectal tumor underwent transsacral excision were analyzed retrospectively. Results Nineteen male and 13 female patients with （62.3±3.7） years old were recruited. The tumors located at 4-8 cm from the anal verge with diameter of 1.5-3.5 cm. After local excision of rectal tumors the rectal wall was repaired with interrupted suture in 25 cases and the anastomosis was used for 7 cases after rectal segment resection. The operation was performed all successfully. There were 21 cases diagnosed by postoperative pathology as villous adenomas with 5 malignant, and 8 cases as tubular adenomas with 1 malignant, and 3 cases as rectal adenocarcinoma. The surgical incised margin was negative in all 9 cases with malignant rectal tumor. Radiochemotherapy was done postoperatively for 3 cases with rectal adenocarcinoma. There was no complication such as fecal incontinence except for anastomotie leakage in one case cured by diverting colostomy. No local recurrence and metastasis was found during the postoperative follow-up from 6 months to 5 years. Conclusions If the proper indication is ensured, transsacral excision of the rectal tumors can produce an expected effect.
出处
《外科理论与实践》
2013年第5期459-462,共4页
Journal of Surgery Concepts & Practice
关键词
直肠肿瘤
外科手术
经骶入路
Rectal tumor
Surgery
Transsacral approach
