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目的评价中下段直肠癌行结肠成形袋结肠-直肠(肛管)吻合术对改善术后排便功能的作用。方法将61例中下段直肠癌患者随机分成2组,第1组31例,制成结肠成形袋后与直肠(肛管)端端吻合(TCP组);第2组30例,行结肠断端与直肠(肛管)端端吻合(CAA组)。分别于术后3、6、12、15个月对患者排便功能进行评价。结果术后15个月时,TCP组患者每日平均排便2次、便后1h内需再排便者占4%、排便失禁综合评价0,均优于CAA组(分别为4次、12%和4);两组比较,差异有显著性意义(P<0.05)。术后6个月时TCP组直肠最大耐受压和顺应性压明显增加,分别为(162.3±2.0)ml/kPa和(28.3±1.7)ml/kPa,与CAA组(154.3±1.9)ml/kPa和(26.5±1.1)ml/kPa相比,差异有显著性意义(P<0.05)。术后两组出现吻合口瘘各1例。TCP组发生吻合口狭窄1例。结论结肠成形袋结肠-直肠(肛管)吻合术能明显改善直肠癌术后患者的排便功能。
Objective To evaluate the effect of colostomy bag colorectal (anal tube) anastomosis in improving the postoperative defecation function in the middle and lower rectal cancer. Methods Sixty-one patients with rectal cancer in the middle and lower stages were randomly divided into two groups. The first group (31 cases) received colorectal neoplasms (TCP group) and the second group (30 cases) Rectal (anal canal) end anastomosis (CAA group). The defecation function of the patients was evaluated at 3, 6, 12 and 15 months after operation. Results At 15 months after operation, the patients in the TCP group had average defecation twice a day, 1 hour after defecation, 4% in rectal defecation and 0 in defecation incontinence, all of which were better than CAA group (4 times, 12% and 4 respectively ). There was significant difference between the two groups (P <0.05). At 6 months after operation, the maximal rectal pressure and compliance pressure were significantly increased in the rectum of TCP group (162.3 ± 2.0) ml / kPa and (28.3 ± 1.7) ml / kPa, respectively, which were significantly higher than those of CAA group (154.3 ± 1.9) ml / kPa and (26.5 ± 1.1) ml / kPa, the difference was significant (P <0.05). One case of anastomotic fistula occurred in the two groups after operation. Anastomotic stenosis occurred in 1 case in TCP group. Conclusion Colostomy bag colon - rectal (anal) anastomosis can significantly improve the defecation function in patients with rectal cancer after operation.