全置入式人造排便控制装置在低位直肠癌患者的应用

Application of implanted artificial defecation control device in patients with lower rectal cancer

目的 探讨全置入式人造排便控制装置应用于低位直肠癌患者的效果。方法 采取“自主控制排便式直肠癌根治手术”对 32例低位直肠癌患者 ,在采取Miles手术对病灶根治性切除的基础上 ,于会阴部重建肛门 ,安装全置入式人造排便控制装置。观测术后不同时期患者排便控制效果、排便方式对患者心理影响 ,以及并发症与不良反应。结果 治疗组 32例中 31例在术后 1个月达到理想排便控制 ,全部病例术后 2个月达到理想排便控制 ,且无明显不良反应及并发症。对照组 16例中 8例在术后 3个月 ,4例在术后 6个月达到排成形大便 1～ 2次 /d的效果。结论 对低位直肠癌患者 ,采取“自主控制排便式直肠癌根治术”能够达到既根治性切除病灶又保持接近生理排便方式的效果 。

Objective To study the effect of applicaton of the implanted artificial defecation control device (IADCD) in patients with lower rectal cancer. Methods The 'radical resection aiming at achieving automatically controlled defecation' was performed in 32 patients with lower rectal cancer, On the basis of Mile's operation, the IADCD was implanted in those patients. Postoperatively, the defection control, psychological effect of the defecation mode on the patients, complications and adverse effects were observed. Results In treatment group (32 cases), satisfactory defecation control was achieved in 31 cases 1 month after the operation, and in another case 2 month after operation, and no obvious complications and untoward effects. In control group(16 cases), 8 cases had 1～2 times formed stool 3 months after operation, 4 cases achieved 6 months after the operation. Conclusions For patients with lower rectal cancer, the 'radical resection aiming at achieving automatically-controlled defecation' could achieve the complete resection of lower rectal tumor and near to normal defecation without obvious untoward effects.