低位直肠癌前切除术J型储粪袋与常规吻合排便功能比较

Comparison of Low Rectal Cancer Resection J Type Manure Storage Bag with Conventional Anastomosis for Defecation Function

目的就低位直肠癌前切除术J型储粪袋与常规吻合排便功能进行比较。方法选取我院2012年1月~2013年1月收治的行低位直肠癌前切除术患者134例,随机分为常吻组（68例）和袋吻组（66例）。常吻组常规用CEEA31型腔内管状吻合器将直肠残端、结肠断端进行端端吻合;袋吻组将断端结肠制成J型储粪袋（5~6cm）,与直肠肛管行端侧吻合。结果袋吻组的平均排便次数、平均大便失禁次数在术后1个月、6个月均明显少于常吻组,袋吻组在术后1个月、6个月的延缓排便能力、需要定期服用缓泻剂和排便控制功能优良等指标也优于常吻组,差异有统计学意义（P〈0.05或P〈0.01）;两组排便功能在术后1年半比较差异无统计学意义（P〉0.05）;两组患者术后并发症比较差异无统计学意义（P〉0.05）,行保守治疗后全部治愈。结论将J型储粪袋应用于低位直肠癌前切除术中,能够有效改善患者排便功能,近期疗效较佳,值得推广。

Objective To compare the low rectal cancer resection J type manure storage bag with conventional anastomosis for defecation function.Methods From January 2012 to January 2013 134 cases of patients with low rectal cancer were enrolled for analysis.All patients were randomly divided into two groups,respectively,the conventional KISS group（68cases）and the bag kiss group（66cases）.Conventional KISS group used the CEEA31 cavity inner tube stapling to anatomize the rectal end residue to the colon end.Bag KISS group made J type manure storage bags to anatomize the end of the colon（5-6cm）with the end of rectum.Results In bag KISS group,the defecation frequency and average number of fecal incontinence 1 months and six months after surgery were significantly less than Conventional KISS group;In KISS bag group 1month and 6months after surgery,the delay capability,the need to regularly take delay evacuant,and defecation control functions such as fine index,were superior to those in conventional KISS group.There were no significant differences between two groups one and half year after surgery in defecation function and postoperative complications.All complications were cured with conservative treatment.Conclusion Applying the J type manure storage bags to low resection of rectal cancer can effectively improve the patients＇ defecation function,with better recent curative effects,and is worthy of promotion.