Per Anum intersphincteric rectal dissection with direct coloanal anastomosis for lower rectal cancer - The ultimate sphincter-preserving operation
Per Anum intersphincteric rectal dissection with direct coloanal anastomosis for lower rectal cancer - The ultimate sphincter-preserving operation
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DOI：
10.1007/bf02062019
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发表时间：
1997-10-01
影响因子：
3.9
通讯作者：
Kitajima, M
中科院分区：
文献类型：
--
作者：
Teramoto, T;Watanabe, M;Kitajima, M
目得：直肠癌保肛手术最重要的目标是确保远端手术安全切缘和肛门括约肌。然而，对于位于直肠极低位置的肿瘤，通过腹部入路横切直肠并确保远端手术安全范围并不总是那么容易。本研究的目的是描述和评价一种新的经肛门括约肌间直肠剥离和结肠肛门吻合术。方法：直肠，包括肛门内括约肌的整个宽度，通过肛门途径周向横切，以在直视下确保手术安全缘，并通过括约肌间平面尽可能向近端移动。经肛门结肠肛门吻合术是在经腹直肠切除术后进行的。结果：该技术已用于12例患者。没有短期或长期吻合口并发症的病例。结论：当吻合必须在齿状线处进行时，该技术是安全的。这是治疗低位直肠癌的最佳保肛手术，不会导致严重的术后肛门功能障碍。
PURPOSE: The most important goal of sphincter-preserving operations for rectal cancer is to secure a distal surgical margin of safety and the anal sphincter. However, it is not always easy to transect the rectum and to secure a distal surgical margin of safety through the abdominal approach for tumors situated extremely low in the rectum. The aim of this study was to describe and to evaluate a new technique of per anum intersphincteric rectal dissection and coloanal anastomosis. METHODS: The rectum, including the entire width of the internal anal sphincter, is transected circumferentially via the anal route to secure the surgical margin of safety under direct vision and is mobilized proximally as far as possible through the intersphincteric plane. Per anum coloanal anastomosis is performed following transabdominal resection of the rectum. RESULTS: This technique has been used in 12 patients. There have been no instances of short-term or long-term anastomotic complications. CONCLUSIONS: This technique is safe when anastomosis must be performed at the dentate line. It is the best sphincter-preserving operation for lower rectal cancer and does not result in serious postoperative anal dysfunction.