Abstract: 【Abstract】〓Objective〓To assess the value of anus preserving operation with sustaining anastomotic tube in laparoscope for lower rectal cancer. Methods〓The alimentary tract reconstruction by colo-rectal (anal) anastomoses with a sustaining anastomotic tube through anal in laparoscope after TME in 14 cases of lower rectal cancer. Results〓Forteen ultralow colo-rectal/anal anastomoses were successfully completed laparoscopically and the anastomosis time was 15-30 min. The mesorectum was cut completely. The distance from stoma to the dentate line was less than 2 cm in 8 patients and colo-anal anastomosis was performed in 6 patients. The function of anal sphincter and micturition recovered smoothly after the operation without anastomotic stoma leakage and anastomotic stoma stenosis. The defecation function was satisfactory in 85.71% (12/14) cases. Postoperative 5 year survival and recurrence were 78.57% (11/14), 7.14% (1/14) respectively by life table method. Conclusion〓The anus preserving operation with sustaining anastomotic tube is safe and practicable in laparoscope for lower rectal cancer.

Key words: Rectal cancer, Laparoscopy, Mesorectal excision, Sustaining anastomotic tube

摘要： 【摘要】〓目的〓探讨腹腔镜下低位直肠癌保肛术中支撑吻合管的应用价值。方法〓腹腔镜下对14例低位直肠癌病人实施全直肠系膜切除(TME)根治性切除,用支撑吻合管完成超低位结直肠-肛管吻合术。结果〓超低位结直肠-肛管吻合成功14例,吻合时间l5~30 min,直肠系膜均完整切除,其中结肠与外科肛管吻合8例,结肠与解剖肛管吻合6例。术后病人肛门括约肌功能、排尿功能良好,未发生吻合口狭窄与吻合口瘘者。术后6个月排便功能优良率为85.71%(12/14)。寿命表法计算5年生存率和局部复发率分别为78.57%(11/14)及7.14%(1/14)。结论〓腹腔镜下低位直肠癌保肛术中支撑吻合管的应用是安全可行的。

关键词: 直肠癌, 腹腔镜检查, 直肠系膜切除术, 支撑吻合管