Role of Curved-Cutter-Stapler in Anus-Preserving for Low Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HU Junchuan , PAN Hua , WANG Qianqing , YANG Qian , FENG Qiang

Emergency Center, People’s Hospital of Sichuan Province, Chengdu 610072, ChinaCorresponding Author: HU Jun-chuan, E-mail: 353776656@qq.com;

Corresponding author：

Keywords：

Low rectal cancer; Anus-preserving; Curved-cutter-stapler; Anastomotic leakage; Anastomotic stenosis; Complication

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Objective　 To evaluate the role of curved-cutter-stapler in anus-preserving for low rectal cancer.
Methods 　The clinical data of 32 patients with low rectal cancer from June 2007 to December 2008 who received low anterior resection and ultra low anterior resection by using curved-cutter-stapler were reviewed retrospectively.
Results 　No operation death case, complete cutting and safe closure in all cases, one case was complicated with anastomotic leakage, and one case of rectovaginal fistula. Thirty patients were followed up 4 to 22 months after the operation, with an average time of 12.6 months, no hemorrhea of pelvic cavity and anastomotic stoma or anastomotic stenosis cases.
Conclusion 　Curved-cutter-stapler has the advantages of complete cutting, safe closure and low complications, and easy being used in anus-preserving operation for low rectal cancer, which can increase the rate of anus-preserving.

Citation： HU Junchuan,PAN Hua,WANG Qianqing,YANG Qian,FENG Qiang. Role of Curved-Cutter-Stapler in Anus-Preserving for Low Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(10): 796-799. doi: Copy

1.	郁宝铭. 结直肠癌外科治疗的现状和展望 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(9): 631-636.
2.	喻德洪. 直肠肿瘤 [A]. 吴阶平, 裘法祖主编. 黄家驷外科学 [M]. 第6版. 北京: 人民卫生出版社, 2003: 1193-1202.
3.	张志强. 全直肠系膜切除并单吻合器在低位直肠癌根治术中的应用 [Ｊ]. 中国基层医药, 2006； 13(4): 566-567.
4.	李世拥, 于波, 梁振家, 等. 直肠癌根治术618例疗效分析 [Ｊ]. 中华外科杂志, 2005; 43(19): 1259-1261.
5.	周总光. 直肠癌全直肠系膜切除根治术涉及的若干问题 [Ｊ].中华胃肠外科杂志, 2006; 9(2): 96-98.
6.	李世拥. 努力提高直肠癌外科诊治水平 [Ｊ]. 解放军医学杂志, 2006; 31(9): 847-850.
7.	Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8): 894-899.
8.	郁宝铭. 低位直肠癌的诊治进展 [Ｊ]. 中国实用外科杂志, 2002; 22(1): 34-36.
9.	李世拥, 于波, 骆成玉, 等. 经腹经肛门切除低位直肠癌经肛门行结直肠黏膜吻合术32例报告 [Ｊ]. 中华普通外科杂志, 2000; 15(4): 229-231.
10.	赵文军, 张才全, 王青. 直肠癌远端肠壁浸润的研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1): 94-96.
11.	郁宝铭, 李东华, 沈耀祥, 等. 低位直肠癌保留肛门手术的评价 [Ｊ]. 中华普通外科杂志, 1998； 13（6）: 352-354.
12.	王小林, 卿三华, 黄祥成, 等. 直肠癌直肠系膜扩散的临床病理观察 [Ｊ]. 中华胃肠外科杂志, 2002; 5(3): 210-212.
13.	韩方海, 张肇达, 周总光, 等. 弧形切割吻合器在低位直肠癌超低位前切除术中的应用 [Ｊ]. 中华胃肠外科杂志, 2007; 10(1): 60-63.
14.	MkelJT, Kiviniemi H, Laitinen S. Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis [Ｊ]. Dis Colon Rectum, 2003; 46(5): 653-660.
15.	Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery－the clue to pelvic recurrence? [Ｊ]. Br J Surg, 1982； 69(10): 613-616.
16.	Peeters KC, Tollenaar RA, Marijnen CA, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer [Ｊ]. Br J Surg, 2005； 92(2): 211-216.
17.	Detry RJ, Kartheuser A, Delriviere L, et al. Use of the circular stapler in 1000 consecutive colorectal anastomoses: experience of one surgical team [Ｊ]. Surgery, 1996; 117(2): 140-143.
18.	汪建平, 吴小剑, 宋新明, 等. 不同时期低位直肠癌根治手术保肛率的变化及其因素分析 [Ｊ]. 中华胃肠外科杂志, 2006; 9(2): 107-110.
19.	李东华, 郁宝铭, 郑民华, 等. 低位前切除术后吻合口瘘的探讨 [Ｊ]. 中华胃肠外科杂志, 2000; 3(4): 243-244.
20.	刘萌华. 低位直肠癌吻合口瘘和直肠阴道瘘的预防与处理 [Ｊ]. 中国实用外科杂志, 2007; 27(6): 448-450.
21.	崔小兵, 管郑生, 付聿铭. 单吻合器在直肠癌超低位前切除术中的应用 [Ｊ]. 临床肿瘤学杂志, 2007; 12(2): 108-111.
22.	Marusch F, Koch A, Schmidt U, et al. Value of a protective stoma in low anterior resections for rectal cancer [Ｊ]. Dis Colon Rectum, 2002; 45(9): 1164-1171.
23.	陈继贵, 路直美, 陈华荣, 等. 直肠癌前切除术吻合口漏预防方法的探讨 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 329-330.
24.	邵永孚, 吴铁成, 单毅, 等. 直肠癌前切除吻合器吻合652例的疗效分析 [Ｊ]. 中华普通外科杂志, 2005; 20(1): 30-32.
25.	Tocchi A, Mazzoni G, Lepre L, et al. Prospective evaluation of omentoplasty in preventing leakage of colorectal anastomosis [Ｊ]. Dis Colon Rectum, 2000; 43(7): 951-955.
26.	于波, 李世拥, 梁振家, 等. 直肠癌保肛术与Miles术临床疗效比较分析 [Ｊ]. 中华外科杂志, 2007; 45(17): 1176-1178.
27.	杜江, 王崇树, 魏寿江, 等. 直肠癌术中区域化疗的临床病理观察 [Ｊ]. 中国普外基础与临床杂志, 2008； 15(12): 926-928.
28.	郑斌. 中低位直肠癌TME并双吻合器吻合术后吻合口效果观察 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(6): 481-482.

1. 郁宝铭. 结直肠癌外科治疗的现状和展望 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(9): 631-636.
2. 喻德洪. 直肠肿瘤 [A]. 吴阶平, 裘法祖主编. 黄家驷外科学 [M]. 第6版. 北京: 人民卫生出版社, 2003: 1193-1202.
3. 张志强. 全直肠系膜切除并单吻合器在低位直肠癌根治术中的应用 [Ｊ]. 中国基层医药, 2006； 13(4): 566-567.
4. 李世拥, 于波, 梁振家, 等. 直肠癌根治术618例疗效分析 [Ｊ]. 中华外科杂志, 2005; 43(19): 1259-1261.
5. 周总光. 直肠癌全直肠系膜切除根治术涉及的若干问题 [Ｊ].中华胃肠外科杂志, 2006; 9(2): 96-98.
6. 李世拥. 努力提高直肠癌外科诊治水平 [Ｊ]. 解放军医学杂志, 2006; 31(9): 847-850.
7. Heald RJ, Moran BJ, Ryall RD, et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997 [Ｊ]. Arch Surg, 1998; 133(8): 894-899.
8. 郁宝铭. 低位直肠癌的诊治进展 [Ｊ]. 中国实用外科杂志, 2002; 22(1): 34-36.
9. 李世拥, 于波, 骆成玉, 等. 经腹经肛门切除低位直肠癌经肛门行结直肠黏膜吻合术32例报告 [Ｊ]. 中华普通外科杂志, 2000; 15(4): 229-231.
10. 赵文军, 张才全, 王青. 直肠癌远端肠壁浸润的研究 [Ｊ]. 中国普外基础与临床杂志, 2006; 13(1): 94-96.
11. 郁宝铭, 李东华, 沈耀祥, 等. 低位直肠癌保留肛门手术的评价 [Ｊ]. 中华普通外科杂志, 1998； 13（6）: 352-354.
12. 王小林, 卿三华, 黄祥成, 等. 直肠癌直肠系膜扩散的临床病理观察 [Ｊ]. 中华胃肠外科杂志, 2002; 5(3): 210-212.
13. 韩方海, 张肇达, 周总光, 等. 弧形切割吻合器在低位直肠癌超低位前切除术中的应用 [Ｊ]. 中华胃肠外科杂志, 2007; 10(1): 60-63.
14. MkelJT, Kiviniemi H, Laitinen S. Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis [Ｊ]. Dis Colon Rectum, 2003; 46(5): 653-660.
15. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery－the clue to pelvic recurrence? [Ｊ]. Br J Surg, 1982； 69(10): 613-616.
16. Peeters KC, Tollenaar RA, Marijnen CA, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer [Ｊ]. Br J Surg, 2005； 92(2): 211-216.
17. Detry RJ, Kartheuser A, Delriviere L, et al. Use of the circular stapler in 1000 consecutive colorectal anastomoses: experience of one surgical team [Ｊ]. Surgery, 1996; 117(2): 140-143.
18. 汪建平, 吴小剑, 宋新明, 等. 不同时期低位直肠癌根治手术保肛率的变化及其因素分析 [Ｊ]. 中华胃肠外科杂志, 2006; 9(2): 107-110.
19. 李东华, 郁宝铭, 郑民华, 等. 低位前切除术后吻合口瘘的探讨 [Ｊ]. 中华胃肠外科杂志, 2000; 3(4): 243-244.
20. 刘萌华. 低位直肠癌吻合口瘘和直肠阴道瘘的预防与处理 [Ｊ]. 中国实用外科杂志, 2007; 27(6): 448-450.
21. 崔小兵, 管郑生, 付聿铭. 单吻合器在直肠癌超低位前切除术中的应用 [Ｊ]. 临床肿瘤学杂志, 2007; 12(2): 108-111.
22. Marusch F, Koch A, Schmidt U, et al. Value of a protective stoma in low anterior resections for rectal cancer [Ｊ]. Dis Colon Rectum, 2002; 45(9): 1164-1171.
23. 陈继贵, 路直美, 陈华荣, 等. 直肠癌前切除术吻合口漏预防方法的探讨 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(3): 329-330.
24. 邵永孚, 吴铁成, 单毅, 等. 直肠癌前切除吻合器吻合652例的疗效分析 [Ｊ]. 中华普通外科杂志, 2005; 20(1): 30-32.
25. Tocchi A, Mazzoni G, Lepre L, et al. Prospective evaluation of omentoplasty in preventing leakage of colorectal anastomosis [Ｊ]. Dis Colon Rectum, 2000; 43(7): 951-955.
26. 于波, 李世拥, 梁振家, 等. 直肠癌保肛术与Miles术临床疗效比较分析 [Ｊ]. 中华外科杂志, 2007; 45(17): 1176-1178.
27. 杜江, 王崇树, 魏寿江, 等. 直肠癌术中区域化疗的临床病理观察 [Ｊ]. 中国普外基础与临床杂志, 2008； 15(12): 926-928.
28. 郑斌. 中低位直肠癌TME并双吻合器吻合术后吻合口效果观察 [Ｊ]. 中国普外基础与临床杂志, 2009; 16(6): 481-482.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Role of Curved-Cutter-Stapler in Anus-Preserving for Low Rectal Cancer

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