Objective To explore the experience of total mesorectal resection of the anal margin anastomosis for ultra-low rectal cancer. Methods Twelve patients of ultra-low rectal cancer were enrolled in this study (8 males and 4 females,47~72 years old, 56.3 in average), including 3 cases of tubular carcinoma, 6 cases of medium differentiated adenocarcinoma, and 3 cases of adenoma transforming. The levels of CEA were increased in 8 patients and normal in 4 patients. Preoperative ultrasound showed cancer had not spread out of the superficial myometrial and did not form a ring intestine growth. All the patients were of Dukes stages B and were performed total mesorectal resection of the anal margin anastomosis. Results All the patietfts showed no anastomotic fistula and anal stenosis. Six patients drop the stapler nail under the caudal anesthesia after one month because of anastomosis pain in defecation. All the patients had feel of defecation after operation. The patients were followed up for 3~6 months, 10 of which defecated no more than 3 times, and 2 no more than 5 times. Conclusion Total mesorectal resection of the anal margin anastomosis is a safe and effective method for patients with ultra-low rectal cancer under Dukes stages B.%目的 探讨超低位直肠癌全直肠系膜切除肛缘吻合术的方法.方法 本组12例,其中男8例,女4例.年龄47～72岁,平均56.3岁；其中高分化腺癌3例、中分化腺癌6例,腺瘤恶变3例；CEA水平升高8例,正常水平4例.术前腔内B超提示癌肿均未超过浅肌层,未形成环肠腔生长.Dukes分期均为B期.采用全直肠系膜切除肛缘吻合术.结果 所有12例患者均未出现吻合口瘘和肛门狭窄,6例患者因术后肛门排便疼痛于1个月后在骶麻下摘除吻合器钉.术后均有便意和排便感觉.全部病例随访3～6个月,排便次数≤3次10例,4～5次2例.结论 超低位直肠癌Dukes分期不超过B期的病例实行直肠癌全直肠系膜切除肛缘吻合术是一种有效的保肛方法.
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