背景与目的:直肠癌术后吻合口瘘是严重的并发症之一,降低吻合口瘘发生率是临床亟待进一步解决的问题,本研究探讨使用双吻合器进行直肠前切除术(Dixon术)后吻合口瘘的发生及原因分析。方法:回顾性分析150例使用双吻合器进行直肠前切除术...背景与目的:直肠癌术后吻合口瘘是严重的并发症之一,降低吻合口瘘发生率是临床亟待进一步解决的问题,本研究探讨使用双吻合器进行直肠前切除术(Dixon术)后吻合口瘘的发生及原因分析。方法:回顾性分析150例使用双吻合器进行直肠前切除术的患者,对术后发生吻合口瘘的患者进行性别、年龄、身体质量指数(body mass index,BMI)、细胞分化程度、吻合口部位、TNM分期、是否合并糖尿病、是否合并术前贫血及是否进行术前新辅助放疗的单因素分析,旨在进一步判断直肠前切除术后吻合口瘘的风险。结果:150例患者中共7例发生吻合口瘘,其中3例行二次手术回肠造瘘,4例保守治疗后愈合。单因素分析及多因素分析证实,吻合口距肛距离、术前新辅助放疗是影响直肠癌术后吻合口瘘的独立危险因素。结论:使用双吻合器技术进行直肠前切除的吻合其术后吻合口瘘发生率相对较低,吻合口距肛距离、术前新辅助放疗是影响直肠癌术后吻合口瘘的独立危险因素,对于吻合口瘘的高危患者可以考虑选择性的进行保护性小肠造口。展开更多
We performed a descriptive retrospective study of sexual and urinary disorders after treatment of rectal cancer by radiotherapy and/or surgery at the Dantec University Hospital in Dakar from 2008 to 2015. The objectiv...We performed a descriptive retrospective study of sexual and urinary disorders after treatment of rectal cancer by radiotherapy and/or surgery at the Dantec University Hospital in Dakar from 2008 to 2015. The objective of the study was to evaluate these sexual and urinary complications and the factors influencing it. We have collected 50 patients. The average age of is 55.7 years with a sex ratio of 0.78. The dominant clinical signs are rectorrhagia (66.0%). Endoscopy (94.0% of patients) showed an ulcerative-budding appearance in 84.0% of cases. The preferred location was the lower rectum 66.0%). The predominant histologic type is adenocarcinoma lieberkunien (82.0%). Computed tomography is performed in 78% of cases and MRI in 30%. Stage III accounts for 70.0% of cases. Thirty-two patients (64.0%) were treated with conventional 2-beam 2D radiation therapy with or without chemotherapy. The total dose of 46 Gy in 23 sessions was the most used, found in 22 patients;30 Gy in 10 sessions in 9 cases. And 16 Gy in 10 sessions, found in 1 case. Surgery performed was abdominoperineal amputation (58.0%) and conservative surgery (42.0%). We note a complete response in 28.0% of patients;8.0%, an increase of 16.0% and a stabilization of 4.0%. The sexual disorders are more important after radiotherapy compared to non-irradiated patients: 31.3% vs 5.6% (p = 0.035). We observe respectively that 2%, 6% and 8% of our patients had urinary disorders in the form of acute retention, urinary incontinence, and urinary burning. Patient follow-up time was between 0 and 42.83 months with an estimated average of 34.9 ± 3.37. The evolution is marked at 6 months by a persistence of sexual disorders in 63.8% of cases and urinary dysfunction in 4% of cases.展开更多
文摘背景与目的:直肠癌术后吻合口瘘是严重的并发症之一,降低吻合口瘘发生率是临床亟待进一步解决的问题,本研究探讨使用双吻合器进行直肠前切除术(Dixon术)后吻合口瘘的发生及原因分析。方法:回顾性分析150例使用双吻合器进行直肠前切除术的患者,对术后发生吻合口瘘的患者进行性别、年龄、身体质量指数(body mass index,BMI)、细胞分化程度、吻合口部位、TNM分期、是否合并糖尿病、是否合并术前贫血及是否进行术前新辅助放疗的单因素分析,旨在进一步判断直肠前切除术后吻合口瘘的风险。结果:150例患者中共7例发生吻合口瘘,其中3例行二次手术回肠造瘘,4例保守治疗后愈合。单因素分析及多因素分析证实,吻合口距肛距离、术前新辅助放疗是影响直肠癌术后吻合口瘘的独立危险因素。结论:使用双吻合器技术进行直肠前切除的吻合其术后吻合口瘘发生率相对较低,吻合口距肛距离、术前新辅助放疗是影响直肠癌术后吻合口瘘的独立危险因素,对于吻合口瘘的高危患者可以考虑选择性的进行保护性小肠造口。
文摘We performed a descriptive retrospective study of sexual and urinary disorders after treatment of rectal cancer by radiotherapy and/or surgery at the Dantec University Hospital in Dakar from 2008 to 2015. The objective of the study was to evaluate these sexual and urinary complications and the factors influencing it. We have collected 50 patients. The average age of is 55.7 years with a sex ratio of 0.78. The dominant clinical signs are rectorrhagia (66.0%). Endoscopy (94.0% of patients) showed an ulcerative-budding appearance in 84.0% of cases. The preferred location was the lower rectum 66.0%). The predominant histologic type is adenocarcinoma lieberkunien (82.0%). Computed tomography is performed in 78% of cases and MRI in 30%. Stage III accounts for 70.0% of cases. Thirty-two patients (64.0%) were treated with conventional 2-beam 2D radiation therapy with or without chemotherapy. The total dose of 46 Gy in 23 sessions was the most used, found in 22 patients;30 Gy in 10 sessions in 9 cases. And 16 Gy in 10 sessions, found in 1 case. Surgery performed was abdominoperineal amputation (58.0%) and conservative surgery (42.0%). We note a complete response in 28.0% of patients;8.0%, an increase of 16.0% and a stabilization of 4.0%. The sexual disorders are more important after radiotherapy compared to non-irradiated patients: 31.3% vs 5.6% (p = 0.035). We observe respectively that 2%, 6% and 8% of our patients had urinary disorders in the form of acute retention, urinary incontinence, and urinary burning. Patient follow-up time was between 0 and 42.83 months with an estimated average of 34.9 ± 3.37. The evolution is marked at 6 months by a persistence of sexual disorders in 63.8% of cases and urinary dysfunction in 4% of cases.
