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Miles手术作为直肠下段癌和肛管癌的根治性手术,普遍应用于临床。但由于切除范围广、功能性损坏大及永久性肠造口等因素,对病人术后的某些正常功能——如排便功能、排尿功能、性功能等影响较大;手术并发症和术后肠造口所出现的问题严重影响了病人术后的生活和生存质量。正确的围手术期处理手术前准确估计病变范围和手术叨除范围,术中正确和安全地操作及术后正确处理肠造口,是减少对病人正常功能的影响、提高病人术后生活和生存质量的关键。现结合我们的经验,对Miles手术围手术期处理的有关问题进行了详细的讨论。
Miles surgery as a radical operation for lower rectal cancer and anal canal cancer is widely used in clinical practice. However, due to factors such as wide range of resection, large functional damage, and permanent colostomy, some of the normal functions of the patient, such as defecation function, urinary function, sexual function, etc., are greatly affected; surgical complications and postoperative The problems of intestinal stoma have seriously affected the postoperative life and quality of life of patients. The correct perioperative management of the preoperative assessment of the extent of the lesion and the extent of the surgical evacuation, the correct and safe operation during the operation and the correct handling of the colostomy postoperatively, are to reduce the impact on the patient’s normal function and improve the patient’s postoperative life and survival. The key to quality. Based on our experience, we discuss the issues related to perioperative management of Miles surgery in detail.