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低位直肠癌中选择部分病例实施保肛手术是可行的.报道了选择62例低位直肠癌在扩大根治术基础上,保留肛门括约肌,术式为经肛门环扎式结肠一直肠(肛管)吻合术.术后上方淋巴结转移率53.4%,侧方淋巴结转移率17.2%,下方淋巴结转移率0%,转移度9.1%.随访1～3年,未见盆腔软组织、淋巴结、吻合口复发.因肝转移死亡5例.影响低位直肠癌保肛术后生存率主要原因是血行转移,不是局部复发.低位直肠癌中合理选择手术适应证和保证根治的前提下积极实施保肛手术是可行的.
It is feasible to select some cases of low rectal cancer to perform sphincter preserving operation. It is reported that 62 cases of low rectal cancer are selected based on the extended radical resection, and the anal sphincter is preserved. The trans-anal cerclage colon has an anastomosis of the intestine (anal canal). The rate of lymph node metastasis was 53.4%, the rate of lateral lymph node metastasis was 17.2%, the rate of lymph node metastasis was 0%, and the degree of metastasis was 9.1%. No pelvic soft tissue, lymph nodes, and anastomotic recurrence were observed during follow-up of 1 to 3 years. Five patients died of metastasis. The survival rate of low rectal cancer after sphincter preserving operation was mainly due to hematogenous metastasis, not local recurrence. It is feasible to actively perform sphincter preserving surgery under the premise of reasonable choice of surgical indication and guaranteeing radical cure in low rectal cancer.