全直肠系膜切除术联合经括约肌间切除术对超低位直肠癌患者Williams分级及肛门功能的影响

Effects of Total Mesorectal Resection Combined with Transsphincterectomy on Williams Classification and A nal Function in Patients with Ultralow Rectal Cancer

目的:探讨全直肠系膜切除术(TME)联合经括约肌间切除术(ISR)对超低位直肠癌患者Williams分级及肛门功能的影响。方法:回顾性分析深圳市宝安人民医院胃肠外科2016年12月-2019年12月收治82例超低位直肠癌患者资料,依据手术方式不同分为对照组(41例)与观察组(41例),对照组采用低位直肠癌保肛术,观察组采用TME+ISR。对比两组术后7d Williams分级及肛门功能。结果:比较两组术后Williams分级情况,观察组A级占比高于对照组,差异有统计学意义(P<0.05);相比对照组,观察组术后7d最大直肠耐受容积(MTV)、最大收缩压(MSP)及肛管静息压(ARP)水平均较高,差异有统计学意义(P<0.05)。结论:超低位直肠癌患者采用TME+ISR治疗效果确切,可有效改善患者肛门功能,利于患者预后,值得临床推广。

Objective:To investigate the effct of total mesorectal excision(TME)combined with transsphincterectomy(ISR)on Williams classification and anal function in patients with ultralow rectal cancer.Methods:The data of 82 patients with ultra-low rectal cancer treated in the hospital from December,2016 to December,2019 were retrospectively analyzed.They were divided into a control group(41 cases)and observation group(41 cases)according to different surgical methods.Anorectal surgery for low rectal cancer was used,and TME+ISR was used in the observation group.The Williams classification and anal function at 7 days after operat ion were compared between the two groups.Results:The postoperative Williams classification was compared between the two groups.The proportion of A grade in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Compared with the control group,the maximum rectal tolerance volume(MTV)7 days after operation,the maximum systolic pressure(MSP)and anal canal resting pressure(ARP)levels are higher,the difference was statistically significant(P<0.05).Conclusion:The treatment effect of TME+ISR in patients with ultra-low rectal cancer is definite.It can effectively improve the patients'anal function and benefit the patients’prognosis.It is worthy of clinical promotion.