低位直肠癌不同保肛术式术后排便功能的比较

Evaluation of the defecation function after different modes of low anastomosis after colonic resection for rectal careinoma

目的 探讨低位直肠癌不同保肛术式术后肛门排便功能。方法 对176例行吻合器吻合术、套入式结肠直肠黏膜吻合术及结肠套叠式原位肛门重建术的低位直肠癌病人，术后随访排便功能2～3年并进行评价。结果 176例术后排便功能优良率为94．9%。其中吻合器吻合术组排便控制优良率100％，正常便意100％。套入式结肠直肠黏膜吻合术组排便控制优良率95．8％，正常便意87．5％。结肠套叠式原位肛门重建术组排便控制优良率84．4G，排便次数无一定规律。结论 排便功能与保肛术式及吻合平面有关，保留解剖肛管者可具有良好排便控制能力。吻合器吻合术和套入式结肠直肠黏膜吻合术术后4～6个月肛门排便功能基本恢复正常。

Objective To evaluate the defecation function after different low anastomosis operations for rectal carcinoma. Methods 176 cases of resection of rectal carcinoma followed by different anal reconstruction techniques （anastomat anastomosis, telescopic colorectal mucosa anastomosis, and in situ colon-telescope anus reconstruction） were followed up for 2-3 years to evaluate the defecation function. Results After operations, the rate of satisfactory defecating function was 94.9% for all the 176 cases. In all the cases in whom the anastomosis was accomplished with anastomat showed good defecating function and normal sensation of defecation. While in telescopic colorectal mucosa anastomosis group and in situ colon-telescope anus reconstruction group, the rate of satisfactory defecating function was 95.8% and 84. 4%, respectively. In 87. 5% of patients with telescopic colorectal mucosa anastomosis there was normal sensation of defecation. The number of defecation did not have a regalarity. Conclusions Methods of anastomosis and its site have an influence on anal function. The control of defecation was normal in the remaining anus. Defecation function asually recovered in some degree during 4-6 months after anastomosis with staplers and telescopic anastomosis.