新辅助化疗和ISR对直肠癌患者肛肠动力学排便功能的影响

Effects of Neoadjuvant Chemotherapy and ISR on Anorectal Dynamics and Defecation in Patients with Rectal Cancer

目的: 探究新辅助化疗辅助ISR对直肠癌患者术后控便功能及肛肠动力学的影响。 方法: 回顾性的选取2015年1月至2016年11月我院行ISR术的73例直肠癌患者作为研究对象,依据治疗方式分为两组,对照组(35例)行常规ISR术,观察组(38例)行新辅助化疗联合ISR术。比较两组患者术后肛肠动力学、排便能力及不良反应。 结果: 两组患者在不同时点组内比较,肛管高压带(HPZ)、肛管静息压(ARP)、肛管最大收缩压(MSP)均变化显著(P<0.05);同时点组间比较,术后1个月、术后3个月及术后6个月,对照组患者ARP、MSP均显著高于对照组患者(P<0.05)。两组患者术后控便能力无显著差异(P>0.05)。两组患者均发生感染、肠梗阻、尿潴留等事件,但两组各不良事件的发生率无显著差异(P>0.05)。 结论: 新辅助化疗联合ISR治疗直肠癌患者,虽对肛肠动力学产生一定的影响,但并不增加排便困难及其他不良事件。

Objective: To explore the effects of neoadjuvant chemotherapy and ISR on anorectal dynamics and defecation in patients with rectal cancer. Methods: 73 rectal cancer patients who underwent ISR in our hospital from January 2015 to November 2016 were selected as the study objects. According to the treatment methods, they were divided into two groups: the control group (35 cases) received conventional ISR, and the observation group (38 cases) received neoadjuvant chemotherapy combined with ISR. The anorectal motility, defecation ability and adverse reactions were compared between the two groups. Results: In the two groups, the changes of hpz, ARP and MSP were significant (P < 0.05) compared with each other at different time points, and the changes of ARP and MSP in the control group were significantly higher than those in the control group at 1 month, 3 months and 6 months after operation (P < 0.05). There was no significant difference between the two groups (P > 0.05). Infection, intestinal obstruction, urinary retention and other events occurred in the 2 groups * but there was no significant difference in the incidence of adverse events between the 2 groups (P>0.05). Conclusion: Neoadjuvant chemotherapy combined with ISR in the treatment of rectal cancer has certain influence on anorectal motility, but it does not increase defecation difficulties and other adverse events.