中国肿瘤外科杂志2025，Vol.17Issue(2)：115-119,5.DOI:10.3969/j.issn.1674-4136.2025.02.002
回肠系膜行盆底重建在低位直肠癌手术中的临床应用
Clinical application of ileal mesentery pelvic floor reconstruction in low rectal cancer surgery
摘要
Abstract
Objective To investigate the safety and clinical efficacy of ileal mesentery pelvic floor reconstruction in resection of low advanced rectal cancer.Methods A retrospective analysis was conducted on the clinical efficacy of ileal mesentery pelvic floor reconstruction in 32 patients with low rectal cancer who underwent Miles,ELAPE,or Hartmann surgery in our hospital from January 2022 to April 2024.The surgical situation,postoperative complications,and prognosis follow-up of the patients were observed.Results 32 patients with low rectal cancer underwent Miles,ELAPE,or Hartmann surgery,in which ileal mesentery pelvic floor reconstruction was used.Among them,22 were male and 10 were female;The age range is 34 to 87 years old,with an average age of 68 years old.The distance between the lower edge of the tumor and the anal margin was 1 to 10 cm,with a median distance of 5 cm.In three cases,the pelvic floor peritoneum was sutured during surgery,resulting in intestinal obstruction.A second surgery was performed to reconstruct the pelvic floor using mesentery,and good therapeutic effects were achieved.The operation time ranged from 130 to 305 minutes(average 218 minutes),the postoperative drainage tube removal time is 6-13 days(average 10 days),and the hospitalization time is 10-35 days(average 19 days).Postoperative pathology showed that the upper and lower margins as well as the circumferential margin of the specimen were negative.The number of lymph nodes cleared ranged from 12-39,with an average of 18 lymph nodes cleared.Among them,there were 2 cases of high differentiation adenocarcinoma,26 cases of low differentiation adenocarcinoma,and 4 cases of low differentiation adenocarcinoma.Postoperative pathological staging:2 cases in stage Ⅰ,11 cases in stage Ⅱ,and 19 cases in stageⅢ.The average follow-up after surgery was 8 months,and all incisions healed in stageⅠwithout any incision infection,rupture,bulging,or intestinal obstruction.No local tumor recurrence or pelvic floor peritoneal hernia was found during the follow-up period.Conclusions Miles,ELAPE,or Hartmann surgery for low rectal cancer using ileal mesentery to reconstruct the pelvic floor can reduce the incidence of postoperative complications and has good clinical application value.关键词
低位直肠癌/回肠系膜/盆底重建Key words
Low rectal cancer/Ileal mesentery/Pelvic floor reconstruction引用本文复制引用
蒋松松,王佳峰,陈刚..回肠系膜行盆底重建在低位直肠癌手术中的临床应用[J].中国肿瘤外科杂志,2025,17(2):115-119,5.基金项目
国家临床重点专科项目(卫办医政函[2012]649号) （卫办医政函[2012]649号）
