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1、临床医学论文•双吻合技术在中低位直肠癌保肛手术中的临床应用作者：张发明曾庆良潘奕程晓明程家平谢铭【摘要】目的：探讨双吻合技术（doublestaplingtechnique,DST）在屮低位直肠癌保肛手术（sphincter-reservingoperation,SPO）中的应用价值及并发症的防治。方法：对比分析采用DST者32例（研究组）与采用单吻合技术者（singlestaplingtechnique,SST）43例（对照组）两组患者临床病理指标、术后并发症及肿瘤复发情况。结果：全组患者手术顺利，无手术死亡。两组患者在术后3个月和6个月时的排便功能比较差异有统计学意义（
2、P<0.05）,但1年后两组大部分患者排便功能基木止常。DST组术后发生吻合口痿3例（9.38%）,吻合口狭窄4例（12.5%）,吻合口出血1例（3.13%）,局部复发2例（6.25%）；SST组术后发生吻合口痿2例（4.65%）,吻合口狭窄3例（6.98%）,吻合口出血2例（4.65%）,局部复发2例（4.65%）。结论：DST在中低位直肠癌手术治疗中是有效、安全的，能够提高中低位直肠癌保肛手术成功率，改善患者生存质量。【关键词】双吻合器•直肠肿瘤•保肛手术Clinicalapplicationofdoublestaplingtechniqueinanus-preserv
3、ingoperationoflowandmiddlerectalcancer【ABSTRACT】Objective:Tostudytheclinicalapplicationandpostoperativecomplicationofdoublestaplingtechnique(DST)inanus・picscrvingopcrationoflowandmiddlerectalcancer・Method:FromApri12002toApri12006,clinicaldataof75caseswithlowandmiddlerectalcancerwereanalyze
4、dretrospectively.Ofthose32casesusedDSTunderwentsphincter-reservingoperation(SPO),regardasstudygroup;and43casesusedSSTreceivedSPO,ascontrolgroup.Clinicalpathologicparameters>postoperativecomplicationandtumorrecurrencewerecomparedbetweenthetwogroups・Results:Operationofal1the75patientswassucc
5、essfulwithoutoperativemortality.InDSTgrouppatients,dcfccationfunctionwasdifferentfromSSTgroupafterpostoperative3and6months(P<0.05),butdefecationfunctionofmostoftwogrouppatientswasbasicallynormalafter1year,andhadnodifference.InDSTgrouppostoperativecomplicationincludedanastomoticleakage3pati
6、ents(9.38%),anastigmaticstricture4patients(12.5%),anastigmaticbleeding1patient(3.13%),localrecurrence2patients(6.25%);inSSTgroupanastigmaticleakage2patient(4.65%),anastomoticstricture3patients(6.98%),anastomoticbleeding2patients(4.65%),localrecurrence2patient(4.65%)・Conclusion:Theclinicala
7、pplicationofDSTwaseffectiveandsafeinsphincterpreservingopcrationoflowandmiddlerectalcancer,enabletoincreasesphincterpreservingoperationachievementratio,elevatepatientsqualityof1ife.[KEYWORDS]Doublestaplingtechnique•RectalNeoplasms•Anus・prcscivingopcration直肠癌中以
