目的評價雙吻合器在中、低位直腸癌保肛手術應用中的安全性和實用性。方法分析 38 例應用雙吻合器行結、直腸吻合治療中、低位直腸癌的經驗。結果本組病例在使用雙吻合器中閉合和吻合過程順利、簡捷，術后無1 例發生吻合口漏; 發生吻合口狹窄1例,發生率為2.6%, 經肛門指法擴肛后即痊愈; 局部復發2例,復發率為5.3%。結論雙吻合器吻合法可作為中、低位直腸癌保肛手術的一種安全可靠的術式選擇。
目的 觀察經肛門吻合器直腸部分切除吻合術（stapler transanal partial resection of rectum，STAPRE）治療直腸脫垂的臨床療效。方法 筆者所在醫院2005年8月至2011年2月期間對長度小于15cm的42例直腸脫垂患者行STAPRE治療。結果 術后隨訪12個月者36例（其中19例超過24個月），隨訪6個月者6例，均未見復發。結論 STAPRE適合Ⅰ、Ⅱ及Ⅲ度直腸脫垂以及年邁和全身狀況不佳的患者，可消除開腹手術帶來的風險。
目的 探討應用國產吻合器行直腸癌前切除雙吻合器吻合術的可行性。方法 對38例直腸癌患者行前切除時，應用國產直線及管狀吻合器行雙吻合器吻合。結果 術后發生吻合口漏2例(5.3%)，1例可能與術后早期腹腔化療有關，另1例形成直腸陰道瘺。全組無吻合口狹窄。結論 國產吻合器在使用上雖不如進口一次性吻合器方便，但如果操作得當，技術熟練，仍可獲類似效果，其費用僅為進口吻合器的1/30。新的改進型中國產品應用更方便，更易使此技術推廣。
目的 探討吻合器痔上黏膜環形切除術（PPH）治療老年人(gt;65歲)重度痔的臨床療效。 方法 采用PPH治療21例老年人重度痔，其中Ⅲ度痔6例，Ⅳ度痔10例，嵌頓混合痔5例，對術后療效及并發癥的情況進行分析。結果 單純PPH手術4例（19.0%）,其余17例（81.0%）均行PPH結合其他手術。平均住院時間8 d，平均手術時間21.4 min。術后76.2%的患者痔核完全回縮，水腫消退。手術當天28.6%的患者疼痛需止痛處理。術后并發癥的發生以下腹部酸脹不適（57.1%）、尿潴留（28.6%）發生多見。平均隨訪21.3周，無肛門狹窄、大便失禁發生，無一例復發，便血5例（23.8%），均為便后少量出血。結論 PPH是適用于老年重度痔的理想術式。
【摘要】目的評估雙吻合器在直腸癌保肛術中的應用價值，并探討吻合口漏等并發癥的防治措施。方法對81例采用雙吻合器行直腸癌前切除術患者的臨床資料進行回顧性分析。結果全組術中腫瘤切除后遠端直腸的縫合、吻合過程順利，手術時間120～190 min,平均160 min。術后發生吻合口漏3例（3.7%），吻合口狹窄1例（1.2%），無手術死亡。結論雙吻合器技術可幫助外科醫生順利完成直腸癌前切除術中結直腸的吻合，并且安全、可靠。
Objective To study the effect of laparoscopic total mesorectal excision and per anum rectal pull-type of anastomosis on male patients with low rectal cancer. Methods The successful experiences of anus saving operation on 23 male patients with low rectal cancer were summarized. Results A laparoscopic total mesorectal excision technique was used, with the full separation of the rectum at the bottom. After pulling out the distal rectum together with the cancer from the anus, the transection of the proximal tumor was performed. The end-to-end anastomosis of rectum and descending colon was performed by tubular stapler. Anus was reserved successfully in the 23 cases. There was no left-tumor stump after surgery detected by postoperative pathological examinations, no anastomotic leakage, and no operative death. Conclusions To the relatively narrow male pelvis, laparoscopic total mesorectal excision and per anum rectal pull-through resection and anastomosis is safe and reliable for anus saving in low rectal cancer. It can simplify the operation, and raise the success rate of sphincter preserving in surgery of low rectal cancer.
目的 探討直腸癌雙吻合器保肛術后預防吻合口漏的措施。方法 回顧性分析2006年1月至2009年7月期間在我院行Dixon術的358例直腸癌患者的臨床資料。結果 本組病例均一次吻合成功,術后出現吻合口漏30例（8.4%），多發生在術后5~10 d,均經非手術綜合性措施治療后漏口愈合,愈合時間14~60 d,中位時間37 d。結論 術前一般狀況調整、術中嚴密操作、正確的引流管放置與灌洗引流、營養支持等綜合性措施對低位直腸癌Dixon術后吻合口漏的防治效果較好。
Objective To explore the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids (PPH) combined with Block operation for obstructed defecation syndrome (ODS). Methods Clinical data of 187 patients with ODS caused by rectocele (RE) who received PPH+Block operation or pure PPH operation in The Chaoyang City Central Hospital from Mar. 2011 to May. 2013, were collected retrospectively, in which 95 patients underwent PPH+Block operation (PPH+Block group) and 92 patients underwent PPH operation (PPH group). Compared the postoperative Longo’s score, postoperative clinical effect, operative effect, and recurrence rate between the 2 groups. Results ① The postoperative Longo’s score: the postoperative Longo’s scores of the PPH+Block group were both lower than those of the PPH group at 1- and 3-year after operation (P<0.05). ② Postoperative curative effect: the total effective rate of the PPH+Block group and the PPH group were both 100%, but the clinical effect of the the PPH+Block group was better than that of the PPH group (Z=–10.15, P<0.05). ③ Operative effect: there was no statistical significance on operative time, intraoperative blood loss, returned to normal activity time, hospital stay, and postoperative visual analogy score (VAS) between the 2 groups (P>0.05). In addition, there were no statistical significance on the incidences of urinary retention, hematochezia, exhaust anal incontinence, and anal fissure between the 2 groups (P>0.05), but the incidence of urgent or high anal straining feeling in the PPH+Block group was significantly higher than that of the PPH group (P<0.05). ④ Medium- and long-term recurrence rate: the recurrence rate of 1-year after operation was similar between these2 groups (P>0.05), but the recurrence rate of 3-year after operation in the PPH+Block group was significantly lower than that of the PPH group (P<0.05). Conclusions The medium clinical effect has no obvious difference between PPH+Block and PPH operation, but the long-term recurrence rate of the former is lower than that of the latter, and the medium- and long-term effect is stable in PPH+Block operation for ODS caused by RE.