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目的 探讨腹腔镜下完成全直肠系膜切除 (TME)、低位 /超低位 /行结肠 -肛管吻合治疗低位直肠癌的可行性。 方法 按TME原则 ,在腹腔镜下对 4 2例低位直肠癌患者实施低位 /超低位 /结-肛吻合术。 结果 4 2例腹腔镜TME、低位 /超低位 /结肠 -肛管吻合术均获成功 ,保肛率 10 0 %。手术时间 (110~ 2 10 )分钟 ,平均 12 5分钟 ;术中出血 (5~ 80 )ml,平均 2 0ml;术后 1~ 2天恢复胃肠功能并下床活动 ,住院时间 (5~ 14 )天 ,平均 8天。术后 18例应用了止痛剂 ,术中及术后均无并发症发生。 结论 腹腔镜下行TME低位 /超低位结肠 -肛管吻合术治疗低位直肠癌可行。具有创伤小、出血少、保肛率高、术后疼痛轻、恢复快等优点外 ,对自主神经丛的保护更准确 ,术后肛门括约肌功能、排尿功能良好
Objective To investigate the feasibility of laparoscopic total mesorectal excision (TME) and low / ultralow / colonic-anal anastomosis in the treatment of low rectal cancer. Methods According to the principle of TME, 42 patients with low rectal cancer underwent laparoscopy for the treatment of low / ultra low / anastomosis. Results 42 cases of laparoscopic TME, low / ultralow / colon - anal anastomosis were successful, anal sphincter rate was 100%. The operation time (110 ~ 210) minutes, an average of 125 minutes; intraoperative bleeding (5 ~ 80) ml, an average of 20ml; 1 to 2 days after the resumption of gastrointestinal function and out of bed activities, hospitalization time ) Days, an average of 8 days. Postoperative analgesics were applied in 18 cases. No complications occurred during and after operation. Conclusion laparoscopic TME low / ultralow colon - anal anastomosis feasible treatment of low rectal cancer. With less trauma, less bleeding, anal sphincter rate, light postoperative pain, recovery and other advantages, the protection of autonomic plexus more accurate, postoperative anal sphincter function, urinary function is good