血吸虫病直肠癌切除后结肠袋状吻合的生理机能评价(英文)

EVALUATION OF PHYSIOLOGIC FUNCTION OF COLONIC POUCH ANASTOMOSES AFTER RECTAL CANCER EXCISION IN SCHISTOSOMIASIS

为探讨血吸虫病直肠癌切除术后结肠袋状吻合的生理学特征。将 46例中段血吸虫病直肠癌切除患者随机分为 A、B 2组 ,A组行直接吻合术 ,B组行结肠袋状吻合术 ,对两组病例的新直肠的生理机能进行评估 ,其中包括实验室研究。结果显示两组病例术后其括约肌压力相似 ,B组病例术后直肠的顺应性得以恢复 ,其顺应性为 0 .2 96 (0 .2 2 4～ 0 .347) L / k Pa,然而 ,A组病例术后顺应性下降 ,顺应性为 0 .194(0 .112～ 0 .2 35 ) L / k Pa,两组比较顺应性差异非常显著 (P<0 .0 0 1)。多元回归分析提示新直肠的顺应性与有利的临床机能有关 ,而肛管运动与不利的临床机能有关。结肠袋状肛管吻合能恢复新直肠的顺应性 。

In order to study physiology value of colonic pouch anastomoses after rectal carcinoma excision in schistosomiasis. 46 patients with total mesorectal excision for carcinoma were randomized into two groups, i.e., straight(Group A,n=23) and colonic pouch anastomosis(Group B,n=23). Neorectal physiologic function of patients in both groups was evaluated including laboratory studies. The results showed that sphincter pressures in both groups were similar. Preoperative compliance of the rectum was restored after surgery in Group B, 0.296(0.224-0.347)L/kPa, but there was a significant decrease after surgery in the Group A, 0.194(0.112-0.235)L/kPa( P <0.001). By a multiple regression analysis, neo rectal compliance was associated with favorable clinical function, and hypermotility of the canal was associated with adverse clinical function. It is suggested that colonic pouch anal anastomosis restores neorectal compliance, which is important for good function after low anterior resection of the rectum.