TNM分期对直肠／肛管癌结肛吻合术近期疗效影响  

Influence of TNM Staging on the Postoperative Short-term Effect of Rectum/Anal Canal Carcinoma Patients Undergoing Colon-Anus Anastomosis

作　　者：吴春生 

机构地区：[1]河南省南阳市张仲景医院普通外科,河南南阳473008

出　　处：《中国肛肠病杂志》2017年第1期7-10,共4页Chinese Journal of Coloproctology

摘　　要：回顾性分析TNM分期对直肠／肛管癌患者结肛吻合术术后近期临床疗效的影响，将行结肛吻合术的直肠／肛管癌患者138例依据TNM分期分为4组，A组（Ⅰ期）21例，B组（Ⅱ期）42例，C组（Ⅲ期）39例，D组（Ⅳ期）36例，比较4组患者术前、术中及术后情况。结果显示，4组患者术前和术中情况差异无统计学意义（P〉0．05），4组患者在住院时间、首次进食时间、下床活动时间、拔除引流管时间、拔除尿管时间和拔除胃管时间差异无统计学意义（P〉0．05），4组患者均未发生吻合口漏和肠梗阻等严重并发症。B组和C组各1例肛周感染，D组2例肺部感染。A、B、C3组的首次排便时间、首次排气时间早于D组（P〈0．05），A、B、C3组组间差异无统计学意义（P〉0．05）。结果表明，结肛吻合术应用于直肠／肛管癌患者的根治性手术，术后近期疗效安全可靠。Ⅳ期直肠／肛管癌患者在行结肛吻合术等姑息性治疗后会存在一定程度的排便、排气时间延长。术后并发症及TNM分期与行结肛吻合术疗效无明确相关性。This study was to retrospectively analyse the influence of TNM staging on the postoperative short-term effect of rectum/anal canal carcinoma patients undergoing colon-anus anastomosis.The 138 patients with above carcinoma who had received the anastomosis were divided into 4 groups according to their TNM stages：group A（Ⅰ stage,21 cases） ,group B（Ⅱ stage,42 cases） ,group C（Ⅲ stage,39 cases） ,and group D（Ⅳ stage,36 cases）;then the 4 group＇s pre-,intra-,as well post-operative status were compared.As results,between the four groups there was no statistical difference in pre-and intra-operative status（ P〉 0.05）, and in the time of hospitalization time, of eating meal at the first time, for ambulation, of removing drainage tube,of withdrawing catheter,and of withdrawing canat of stomach,also so did （ P 〉0.05） ;And, the four groups had not any severe complications such as stoma leakage and intestinal obstruction,;etc;one case suffered from infection perianally in group B and group C,two cases from lung infection in group D;as for the time of defecation at the first-time,and of flatus at the first-time,group A,B,C were all earlier than group D（ P 〈0.05）,but between A,B,C there was no statistical difference（ P 〉0.05）.Results show that colon-anus anastomosis has safe and reliable short-term effect,as for Ⅳ stage patients after colon-anus anastomosis and other palliative treatments they might have the time of defecation and flatus lengthen.And, postoperative complications have no significant relationship with the influence of TNM staging on effect of colon-anus anastomosis.

关 键 词：TNM分期 直肠/肛管癌 结肛吻合术 

分 类 号：R735.370.5[医药卫生—肿瘤]