中文摘要：

目的 探讨套入式结肠直肠黏膜吻合保肛术式治疗中低位直肠癌的临床疗效。方法 对208例中低位直肠癌行套入式结肠直肠黏膜吻合保肛术式经腹肛门根治性切除病例进行回顾性分析。208例中男131例，女77例，年龄21～99岁，平均53．7岁。肿瘤下缘距齿状线6～8cm。Dukes分期A期76例，B期122例，C期10例。病理诊断直肠腺癌201例，其中高分化者86例，中分化者100例，低分化者8例，黏液腺癌7例。腺瘤癌变7例。结果 208例术后随访率为87．5％（182／208），中位随访时间5．9年。术后发生吻合口瘘8例（3．8％），吻合口狭窄3例（1．4％），排便功能在术后12～24周时基本恢复到正常，每日1～3次。术后局部复发率为4．9％（9／182），肝转移率为14．2％（26／182），5年生存率为72．5％。结论 套入式结肠直肠黏膜吻合保肛术式既能保持良好的肛门排便控制功能，又能降低吻合口瘘发生率，局部复发率和5年生存率与Miles手术相同，是一种安全有效的保肛术式。

英文摘要：

Objective To study the clinical efficacy of colorectal mucosa anastomosis in resection of mid-lower rectal cancer to preserve the anus. Methods A retrospective analysis was carried out with 208 cases of mid-lower rectal cancer operated with the said surgical procedure, including 131 males and 77 females, aged 21-99 years with mean age of 53. 7 years. The low margins of the tumors were located 6-8 cm from the anal verge Pathologically, adenocarcinoma accounted for 201 cases, in whom 86 well-differentiated, 100 moderately differentiated, and 8 poorly differentiated, 7 mucinous adenocarcinoma, and 7 adenoma with malignant degeneration. According to Dukes classification, 76 belonged to Dukes＇ A, 122 Dukes＇ B, and 10 Dukes＇ C. Results 182 cases （87. 5%） were followed up, the median follow-up time was 5. 9 years. Postoperative complications included 8 cases （3. 4%） of stoma leak, and 3 cases （1.7%） of stoma stenosis. The defecation function recovered after 12-24 weeks postoperatively, with frequency of 1-3 times each day. Local recurrence was 4. 9% （9/182）. Hepatic metastasis was 14. 2% （26/182）. The five year survival rate was 72. 5%. Conclusion Colorectal mucosa anastomosis is safe and efficacious for rectal cancer. With the procedure, the anal function can be preserved well, the incidence of stoma leak is decreased, and the 5 year survival rate is the same as that of Miles operation.