摘要
目的探讨低位直肠癌保肛术后吻合口位置距齿状线的距离对肛门功能恢复的影响。方法回顾性分析2007年1月至2011年3月期间在我院行低位直肠癌保肛手术患者90例。根据术后吻合口位置距齿状线的距离,将所有病例分为三组:Ⅰ组吻合口位置距齿状线0～ 1.0 cm;Ⅱ组为1.0～ 2.0 cm;Ⅲ组为2.0 cm以上。术后1、3、6和12个月随访并记录患者的肛门功能状况,比较三组间患者肛门功能恢复情况。结果三组患者间,性别、年龄、T分期、Dukes分期、组织学类型比较,差异均无统计学意义(P>0.05)。三组患者术后第6个月肛门功能评价优良率分别为63.3%、80%和83.3%。术后第12个月各组患者的肛门功能恢复达优良的百分率分别为80%、86.7%和93.3%。术后第1、3个月,Ⅰ组患者肛门功能恢复情况差于Ⅱ组(P<0.05),Ⅱ组患者肛门功能恢复情况差于Ⅲ组(P<0.01);术后第6和12个月,Ⅰ组与Ⅱ组之间、Ⅱ组与Ⅲ组之间肛门功能恢复情况比较,差异无统计学意义(P>0.05)。Ⅰ组和Ⅲ组两组患者在术后1、3、6、12个月各时间段,术后肛门功能恢复情况差异均有统计学意义。结论低位直肠癌保肛术后吻合口位置距离齿状线越近,肛门功能恢复情况越差,恢复所需时间越长,大多患者可在术后6个月恢复,患者术后肛门功能恢复的远期效果较好。
Objective To investigate the effect of different anastomotic planes on anal function after low anterior resection for distal rectal cancer.Methods Clinical data of 90 rectal cancer patients with low anterior resection in accordance with the principle of total mesorectal excision and pelvic autonomic nerve preservation from January 2007 to March 2011 in our hospital were analyzed retrospectively.According to the distance from the dentate line to anastomotic plane,the patients were divided into three groups,Group Ⅰwith the distance less than 1.0 cm,Group Ⅱ with the distance from1.0 to 2.0 cm,Group Ⅲ with the distance more than 2 cm.The anal functional scores in the 1st,3rd,6th,12th month after operation were compared among the three groups.Results There were no significant differences in gender,age,T stage,Duke's stage and histological type among the three groups.The percentages of the patients with anal function scores recovered to fine / excellent were 63.3%,80%and 83.3% respectively in the 6th month,and 80%,86.7% and 93.3% in the 12th month after operation.In the 1st,3rd month after operation,there were significant differences in anal function recovery between Group Ⅰ and Group Ⅱ,and between Group Ⅱ and Group Ⅲ,but no differences in the 6th and 12th month after operation.There were significant differences in anal function recovery in the 1st,3rd,6th,12th month after operation between Group Ⅰ and Group Ⅲ.Conclusions The smaller the distance from the dentate line to anastomotic plane,the worse anal function recovery,and more time the patients need to recover anal function.Anal Function can be recovered in most patients in 6 months after operation.
出处
《消化肿瘤杂志（电子版）》
2012年第4期250-254,共5页
Journal of Digestive Oncology(Electronic Version)
关键词
低位直肠癌
保肛手术
肛门功能
Distal rectal cancer
Sphincter preserving surgery
Anal function
