摘要
目的评价结肠J 型贮袋术在中低位直肠癌前切除术中的临床应用价值。方法对1998年 1月至 2 0 0 2年 7月行根治性直肠前切除术治疗的 12 0例中低位直肠癌分为贮袋组 2 2例 ,结肠直肠直接吻合组 98例 ,比较两组的手术情况和术后排便功能。结果中位随访时间为 18个月。两组手术时间、住院天数、术后并发症、复发率和生存率均无显著性差异 (P >0 0 5 )。贮袋组肿瘤下缘距离齿状线距离为 (3 6± 1 5 )cm ,与直接吻合组 (5 2± 1 9)cm相比 ,差异有显著性意义 (P =0 0 0 0 )。术后 3个月和 1年时每日大便次数贮袋组较直接吻合组显著减少 (P <0 0 5 ) ,排便急迫感改善明显 (P <0 0 5 )。术后 2年时两组间上述指标已无显著性差异 (P >0 0 5 )。结论对于低位直肠癌行直肠前切除术时选择结肠J 型贮袋术可以明显改善术后近期的排便功能。
Objective To evaluate J-pouch coloanal anastomosis after low anterior resection for the middle and low rectal carcinoma. Methods From January 1998 to July 2002, 120 patients undergoing low anterior radical resection for the middle or low rectal carcinomas were divided into groups of coloanal anastomosis and that of 5 cm colonic J-pouch-anal anastomosis. WT5”HZResults These two groups were well matched for gender, age and histologic stage. There were no significant differences in operative time, hospital stay, complications, postoperative recurrence rate and postoperative survival time between the two groups as founded by an average follow-up of 18 months. The mean distance from the inferior edge of the tumor to the dentate line was (3 6±1 5) cm in the J-pouch group, significantly less than that in coloanal anastomosis group of (5 2±1 9) cm, ( P =0 000). Defecation frequency, urgency and incontinence were significantly improved at 3 months and 12 months after operation in the J-pouch group ( P <0 05), with the difference dwindling to no significance at 24 months ( P >0 05). Conclusion J-pouch coloanal anastomosis after low anterior resection for the middle and low rectal carcinoma significantly improves the short-term bowel function after operation.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第10期581-584,共4页
Chinese Journal of General Surgery
