J型贮袋直肠吻合术对肛门功能影响的回顾性研究  

Retrospective analysis of colonic J-pouch versus straight reconstruction after low anterior resection with anal preservation for low rectal cancer

作　　者：徐永强[1] 邓兵[1] 刘宁[1] 

机构地区：[1]四川省宜宾市第二人民医院肛肠外科,四川宜宾644000

出　　处：《结直肠肛门外科》2011年第2期79-82,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的评价低位直肠癌前切除保肛术后J型贮袋对改善排便功能的疗效。方法 60例患者行低位直肠癌前切除术以及结直肠或结肛吻合,其中22例应用J型贮袋(贮袋组)、38例应用结直肠或结肛直接吻合(无袋组)。记录并比较两组患者的术后并发症的发生情况及排便情况,对术后6个月和12个月的排便功能进行评估。结果两组间术后并发症发生率无明显差异。6个月后贮袋组患者在夜间溢便、漏稀便、区别排气排便和集团性排便方面明显优于无袋组。在术后6个月、12个月贮袋组的延缓排便均优于无袋组(P<0.05);两组在便不尽、需抗腹泻药和使用缓泻剂方面无显著性差异。结论结肠J型贮袋可改善低位直肠癌前切除患者术后早期的控变能力。Objective To evaluate the short-term functional outcome of colonic J-pouch reconstruction after low anterior resection（LAR） for rectal cancer.Methods Sixty patients with low rectal cancer had a colorectal or coloanal anastomosis after low anterior resection,twenty-two with a J-pouch and thirty-eight with a straight colorectal or coloanal anastomosis.The two groups were compared in terms of postoperative complications and anorectal functional results for 6 months and 12 months intervals of study.Results There was no significant difference between the two groups in complication incidence（P0.05）.At six months,the stool frequency was significant decreased in patients who had a J-pouch than in those with a straight colorectal or coloanal anastomosis（P0.05）.Similarly,significantly better results were seen with regard to nocturnal leak,liquid stool leak,ability to discriminate flatus from feces and group of bowel movements（P0.05）.Patients with J-pouch had better stool deferment at 4,6 and 12 months（P0.05）.There were no significant difference between the two groups in endless of defecate,regular use of retarding medication and regular use of bulking medication（P0.05）.Conclusion The bowel function of the J-pouch was superior to that of the straight colorectal or coloanal anastomosis in patients with low rectal cancer.

关 键 词：结肠J型贮袋 低位直肠癌 低位前切除术 排便功能 

分 类 号：R735.37[医药卫生—肿瘤]