直肠前切除综合征的防范与处理

Prevention and management of anterior resectionsyndrome

近年来，得益于手术技能的提高及新的综合治疗手段应用。更多的直肠癌患者得以保留肛门。然而在保肛手术后高达90％的患者可能出现不同程度的肠道功能障碍，从最轻的排粪次数增多。到严重的排粪失禁和排空障碍。这组在直肠前切除术后出现的各种肠道功能改变引起的症候称为直肠前切除综合征（ARS）。ARS严重影响了患者术后的生活质量，而其根本机制尚有待阐明。本文对该综合征的临床表现、可能的机制及防治策略进行讨论。

Because of the improvement of surgical technique and the widely use of muhimodality therapy, more patients with rectal cancer undergo sphincter-preserving surgery. However, it has been reported that up to 90% of such patients will suffer from bowel dysfunction, ranging from increased bowel frequency to faecal incontinence or evacuatory dysfunction. This wide spectrum of symptoms after resection of the rectum has been termed anterior resection syndrome （ARS）. This disordered bowel function has a substantial negative effect on quality of life, however, the causal mechanisms have not been clarified. The present reviewdiscusses the clinical manifestation, underlying mechanisms, as well as prevention and treatment strategies.