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目的:探讨三吻合器技术在高位直肠癌合并急性肠梗阻一期吻合术中应用的可行性、安全性及临床效果。方法:回顾性分析2009年1月至2013年12月河南省肿瘤医院普外科26例合并急性肠梗阻高位直肠癌患者的临床资料,其中20例采用三吻合器技术完成一期吻合。结果:20例患者均吻合成功,2例术中游离横结肠脾曲后完成吻合;无吻合口瘘、吻合口出血、切口感染、腹腔感染等早期严重并发症。20例患者均获1~12个月随访,术后3周、3个月、6个月分别行泛影葡胺钡灌肠造影,提示吻合口通畅,均未出现吻合口狭窄。结论:三吻合器技术在高位直肠癌合并急性肠梗阻一期吻合术中应用是安全可行的,在降低吻合口瘘、吻合口出血、吻合口狭窄等并发症的发生方面具有一定的优势。
Objective: To investigate the feasibility, safety and clinical effect of triple stapler technique in primary anastomosis of high rectal cancer with acute intestinal obstruction. Methods: The clinical data of 26 patients with acute intestinal obstruction in rectal cancer who underwent general surgery in Henan Cancer Hospital from January 2009 to December 2013 were retrospectively analyzed. Among them, 20 patients underwent primary anastomosis with three stapler technique. Results: All the 20 patients were successful in the anastomosis. Two cases were completed anastomosis after the operation of free transverse colon and splenic song. There were no serious complications such as anastomotic fistula, anastomotic bleeding, incision infection and abdominal infection. All 20 patients were followed up for 1 to 12 months. Three weeks, 3 months and 6 months after operation, diastolic diaphragmatic gancic barium enema was performed respectively, which indicated that the anastomotic patency did not result in anastomotic stenosis. Conclusion: The technique of three staplers is safe and feasible in the first stage of anastomosis of high rectal cancer with acute intestinal obstruction, and it has some advantages in reducing complications such as anastomotic fistula, anastomotic bleeding and anastomotic stenosis.