“U”型肠袢代储袋在低位直肠癌前切除术中的应用

U-type Colonic Loop Substitute for Colonic Pouch in Anterior Resection of Distal Rectal Cancer

目的评价低位直肠癌前切除术后应用U型结肠袢成形代储袋对术后排便功能的影响。方法选取2007年1月至2008年4月收治的40例中下段直肠癌患者,均行直肠前切除低位或超低位吻合,随访1年,分别于术后3、6、9个月按徐忠法"五项十分制"肛门排便功能评价标准对排便功能进行评估。结果术后1例发生吻合口瘘,经保守胃肠外营养后愈合;切口感染2例。术后并发症发生率7.5%(3/40)。术后3、6、9个月排便功能优良率分别为70.0%、77.5%、87.5%。结论在中下段直肠癌行低位(或超低位)吻合术中应用"U"型结肠袢成形代储袋对术后半年内肛门排便功能起到明显的改善作用,未增加并发症发生率,亦未增加手术难度。

Objective To evaluate the effect of U-type colonic loop substitute for colonic pouch on defecation function after anterior resection for distal rectal cancer. Methods 40 patients with mid or low rectal cancer undergoing low or ultra-low colorectal anastomosis between Janunary 2004 and April 2005 were selected into this study and all patients were followed up for one year. The defecation function was evaluated in postoperative 3,6,9 months and was graded according to Xu Zhong fa Anal function Evaluation Methods. Results The morbidity was 7.5% （3/40）. Anas tomotic leakage occurred in one case,and the patient recovered after conservative treatment. Incision infection occurred in two cases. The excellent and good rate of defecation function in postop- erative 3,6,9 months was 70.0% ,77.5% ,87.5%,respectively. Conclusion U-type colonic loop substitute for colonic pouch has the advantage of improving the defecation function within 6 months after anterior resection for distal rectal cancer. This procedure does not increase postoperative complications and surgical difficulty.