【摘要】 [目的]评价侧端吻合术改善低位直肠癌前切除术后排便功能。[方法]对低位直肠癌前切除保肛术病例60例,行结肠—直肠(或肛管)侧端吻合术与结肠—直肠(或肛管)端端吻合术重建消化道各30例,于术后6个月及12个月评价排便功能。[结果]侧端吻合组发生术后并发症7例,端端吻合组发生术后并发症共8例,两组术后并发症发生率无统计学差异(χ2=0.089,P=0.766)。术后6个月时,侧端吻合组大便Ⅰ度失禁发生率为10.0%,明显少于端端组的30.0%(χ2=4.320,P=0.038)。侧端吻合组里急后重发生率为26.7%,明显少于端端组的60.0%(χ2=6.687,P=0.009)。侧端吻合组控便满意率为83.3%,明显好于端端组的60.0%(χ2=4.022,P=0.045)。两组患者在术后12个月控便能力均恢复正常。[结论]侧端吻合术并不增加术后并发症,而且改善近期术后排便功能效果。更多还原

【Abstract】 Purpose To evaluate the bowel function in low rectal cancer patients with side-to-end anastomosis after anterior resection. Methods Sixty cases with low rectal cancer with anus preserving operation of anterior resection were divided into two groups: 30 cases underwent colorectal or coloanal side-to-end anastomosis,and 30 cases underwent colorectal or coloanal end-to-end anastomosis. Bowel function were assessed at 6 and 12months postoperation. Results Postoperative complications developed in 7 cases in side-to-end anastomosis group and 8 cases in end-to-end anastomosis group without significant difference between them (χ2 = 0.089,P = 0.766). At 6 months postoperation,fecal incontinence grade I was 10.0% in side-to-end anasto- mosis group,which was significantly less than that in end-to-end group (30.0%) (χ2 = 4.320,P= 0.038). Tenesmus in side-to-end anastomosis group (26.7% )was significantly less than that in end-to-end group (60.0%)( χ2 =6.687,P=0.009). Satisfaction rate of fecal control in side-to-end anastomosis group was 83.3% ,which was significantly better than that in end-to-end group (60.0%)(χ2 =4.022,P=0.045). All the patients in the two groups recovered to normal fecal control 12 months postoperation. Conclusion Side-to-end anastomosis can improve the postoperative bowel function without increasing postoperative complications for patients with low rectal cancer.更多还原