乙状结肠成形在超低位直肠吻合术中的应用

目的评价乙状结肠成形在超低位直肠吻合术中的临床应用价值。方法对比乙状结肠成形超低位直肠吻合术(观察组,35例)和乙状结肠-直肠超低位吻合术(对照组,33例)两组患者术后并发症发生率及肛门功能恢复情况。结果观察组手术并发症发生率17.1%,对照组21.2%;两组差异无统计学意义(P>0.05)。术后12个月,观察组患者每日大便1～5.5次(平均2次/d),对照组1～9次(平均3.5次/d),两组差异有统计学意义(P<0.01);在大便控制方面观察组明显优于对照组(P<0.01);患者的自我满意程度观察组高于对照组,P<0.01;术后肛门功能得分观察组2.57分,对照组7.21分,两组比较,P<0.01。结论乙状结肠成形应用在超低位直肠吻合术中,不增加手术并发症,术后肛门功能恢复明显优于结肠直肠直接吻合术。

Application of sigmoid coloplasty in super-lower anastomosis

OBJECTIVE: To assess the clinical value of sigmoid coloplasty of super-lower anastomosis. METHODS: Thirty-five patients underwent sigmoid coloplasty (treatment group), while 33 patients received straight sigmoidorectostomy (control group). Complication rate and anal function were observed and compared between the two groups. RESULTS: The complication rate was 17.1% and 21.2% in the study group and control group respectively (P> 0.05). Average stool frequency were 2 times (1-5.5 times) a day in the study group and 3.5 times (1-9 times) a day in the control group 12 months after operation (P< 0.01). The fecal continence and self-satisfaction were improved significantly in the study group than that of the control group(P< 0.01, respectively). The postoperative anal function score was 2.57 in the study group and 7.21 in the control group, there was significant difference between the two groups (P< 0.01). CONCLUSIONS: Compared with straight sigmoidorectostomy, sigmoid coloplasty applied in super-lower anastomosis can significantly improve the recovery of anal function without increasing complication rates.