直肠癌保肛手术中不同造口术联合术后盆底生物反馈治疗对患者肛管直肠功能和并发症发生的影响  

Effect of Anus-Preserving Operation with Different Stoma Procedures in Combination with Postoperative Pelvic Floor Biofeedback on Anorectal Function Related Parameters and Complication Rate in Patients with Rectal Cancer

作　　者：王梦云 杜记涛 程方圆 尚慧 WANG Mengyun;DU Jitao;CHENG Fangyuan(Cancer Hospital Affiliated to Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学附属肿瘤医院,河南省肿瘤医院,450000 [2]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第10期1713-1716,共4页The Practical Journal of Cancer

摘　　要：目的探讨直肠癌保肛手术中不同造口术联合术后盆底生物反馈治疗对患者肛管直肠功能和并发症发生的影响。方法回顾性选取98例低位直肠癌腹腔镜保肛手术患者,按照不同造口方法分组,末端回肠造口术+术后盆底生物反馈治疗为观察组(n=49),横结肠造口术+术后生物反馈治疗为对照组(n=49)。比较2组围手术指标、肛门功能情况、肛管直肠压力指标及并发症发生情况。结果观察组术后首次进食及排便时间、住院时间均低于对照组,差异具有统计学意义(P<0.05)。观察组术后6、12个月wexner评分均低于对照组,差异具有统计学意义(P<0.05)。治疗后观察组直肠静息压、直肠最大耐受量、直肠便意感觉容量、肛管静息压、肛管收缩压、肛管高压长度等均较治疗前高,且观察组增长幅度高于对照组,差异具有统计学意义(P<0.05)。2组并发症发生率差异无统计学意义(P<0.05)。结论低位直肠癌腹腔镜保肛手术采取末端回肠造口术联合术后盆底生物反馈治疗的效果较好,与横结肠造口术相比,更有助于术后患者机体恢复、肛门功能恢复及预后恢复,且并发症相对较少。Objective To investigate the effects of different ostomies combined with postoperative pelvic floor biofeedback therapy on anorectal function and complications in rectal cancer.Methods 98 patients with laparoscopic anal preservation surgery for low rectal cancer were retrospectively selected and grouped according to different ostomy methods:terminal ileostomy+postoperative pelvic floor biofeedback treatment was the observation group(n=49),and transverse colostomy+postoperative biofeedback treatment was the control group(n=49).Perioperative indexes,anal function,anorectal pressure indexes and complications were compared between the 2 groups.Results The time of first postoperative eating,defecation and hospitalization in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The wexner score of the observation group was lower than that of the control group 6 and 12 months after surgery,and the difference was statistically significant(P<0.05).After treatment,rectal resting pressure,maximum rectal tolerance,rectal defecation sensation capacity,anal canal resting pressure,anal canal systolic pressure and anal canal high pressure length in the observation group were higher than before treatment,and the increase rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Complication incidence rates between the 2 groups had no statistically significant difference(P<0.05).Conclusion Laparoscopic anal preservation surgery for low rectal cancer combined with distal ileostomy and postoperative pelvic floor biofeedback has better effects.Compared with transverse colostomy,laparoscopic anal preservation surgery is more conducive to postoperative body recovery,anal function recovery and prognosis recovery of patients,with relatively few complications.

关 键 词：直肠癌 保肛手术 末端回肠造口术 横结肠造口术 生物反馈治疗 

分 类 号：R735.3[医药卫生—肿瘤]