摘要
目的评价低位直肠癌低位吻合术后排便功能。方法对６７例低位直肠癌用经肛门环扎结肠直肠（肛管）吻合术，术后随访排便功能２～３年。以徐忠法五项十分评价标准，结合肛门指诊，吻合口位置，术后时间综合分析判断。结果排便功能优良率７１％，吻合平面在外科肛管：排便控制良可率１００％；正常便意７６％；排便感觉区分率９８％。肌间沟平面：排便控制良可率８０％左右，排便次数无一定规律。结论吻合平面与排便功能有关，保留解剖肛管可有良好控制力。区分感觉和吻合平面无关。保留正常便意需保留齿线以上２～４ｃｍ直肠。术后３～６个月排便功能有一定程度恢复。
Objectives To evaluate of anal function in rectal carcinoma patients after low anastomosis operation.Methods 67 cases of low rectal carcinoma were followed up for 1～3years about anal function after circumdesisal colon～rectum(anal) anastomosis through anus.The analysis and decision were done according to Xu Zhongfa valuating standard digital examination of rectum,anastomotic position and postoperative period.Results The rate of good anal function was 71%.The anastomotic position was at surgical anal level,normal anal function was 100%;at anatomical anal level,normal anal function 100%,mormal sensation of defecation 48%,ability to distinguish different sensation of defecation 98%;at white line level,normal anal function 86%,normal sensation of defecation 33%,ability to distinguish different sensation of defecation 80%.There wasn't a certain regulation about numbers of defecation.Conclusions Anastomotic position related with anal function.The control of defecation was normal in remaining anatomical anal.There wasn't relation between anastomotic position and ability to distinguish sensation.The sensation of defecation was normal if rectum of 24 cm above dentaleline was remained.And function recovered in some degre during 36 months after operation.
