直肠癌前切除、结肠“J”型储袋对术后排便功能的影响

目的为探讨直肠癌行低位前切除术后应用结肠“J”型储袋行直肠或肛管吻合能否改善患者的排便功能。方法对2000年1月至2001年1月间连续行低位前切除术的72例中、下段直肠癌患者行回顾性分析。根据吻合方式分为两组：“J”型储袋组，共33例；直接吻合组，共37例。分别于术后1、3、6及12个月，对手术并发症及排便功能行比较性研究。结果发现两组均无手术死亡及术后出血病例。直吻组发生吻合口瘘2例；储袋组及直肠组术后吻合口狭窄分别为2例及1例；局部复发者各为3例；肝转移分别为2例及3例。“J”型储袋组较直接吻合组患者术后6个月及12个月之日排便次数及夜间排便人数比率均明显减少（7次vs3次，P〈0．05；3次VS1次，P〈0．05），（64％VS31％，P〈0．05；30％VS3．9％，P〈0．05）。前者大便失禁综合评分显著优于后者（8VS2，P〈0．05；5．2VSL5，P〈0．05）。结论结果表明直肠癌行低位前切除术后，应用“J”型储袋行直肠或肛管吻合，不增加手术并发症，且在术后1年内，可以在某些方面改善患者排便功能。

Effect of colonic J-pouch anastomosis on bowel function after low anterior resection in patients with mid or low rectal cancer

Objective To investigate the effect of colonic J-pouch anastomosis on bowel function after low anterior resection(LAR) in patients with mid or low rectal cancer.Methods A retrospective review was made in 72 consecutive patients underwent LAR between January 2000 and January 2001.Thirty-three patients in J-pouch group had a stapled colonic J-pouch coloanal anastomosis and 39 in non-pouch group had a stapled coloanal anastomosis.The patients were followed up and evaluated at postoperative 1,3,6 and 12 months....