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目的探讨纵向部分括约肌切除术治疗超低位直肠癌的临床疗效。方法回顾性分析2004年1月至2008年4月中国医科大学附属盛京医院行纵向部分括约肌切除术治疗超低位直肠癌12例病人的临床资料,采用向量测压来评价其临床疗效。结果中位随访35.5个月,均未出现局部复发,仅1例在术后24个月出现远处转移并行左半肝切除。向量测压结果显示术后最大静息压和收缩压明显升高,而静息向量容积和收缩向量容积明显降低,不均衡指数在静息状态和收缩状态均显著升高。所有指标随着时间的推移逐渐趋于正常。结论超低位直肠癌病人采用纵向部分括约肌切除术能够获得足够的根治性和可接受的肛门功能。
Objective To investigate the clinical effect of longitudinal partial sphincterotomy in the treatment of ultra-low rectal cancer. Methods The clinical data of 12 cases of ultralow rectal cancer treated by longitudinal partial sphincterotomy at Shengjing Hospital of China Medical University from January 2004 to April 2008 were retrospectively analyzed. The curative effect was evaluated by vector manometry. Results The median follow-up of 35.5 months, no local recurrence, only 1 case of 24 months after the emergence of distant metastasis and left hemihepatectomy. The results of vector manometry showed that the maximum resting pressure and systolic pressure increased significantly, while the volume of resting vector and systolic volume decreased significantly. The unbalance index increased significantly in resting state and contracted state. All indicators gradually became normal over time. Conclusion Longitudinal partial sphincterotomy in patients with ultra-low rectal cancer can obtain adequate radical and acceptable anal function.