经肛门全直肠系膜切除术后肛门功能评估现状及研究进展

Current status and research progress in the assessment of anal function after transanal total mesorectal resection

目的总结当前直肠癌保肛术后常用的肛门功能评估方法,并总结经肛门全直肠系膜切除术(taTME)后患者肛门功能的研究现状和存在的问题。方法通过检索国内外数据库的相关文献,综述直肠癌保肛术后肛门功能评估工具及taTME术后肛门功能评估现状。结果目前关于taTME术后肛门功能恢复的文献较少,尤其是术后远期肛门功能的恢复情况尚不明确。传统直肠癌保肛术后的早期肛门功能可能优于taTME,但两者术后中期及远期的肛门功能恢复情况相当;在研究工具方面,目前多数研究倾向于使用量表评估法来对taTME术后的肛门功能恢复进行描述,而关于客观性量化指标,如肛门直肠测压、肛管内超声等的使用尚较少。结论目前对于taTME术后肛门功能的研究存在研究工具单一、不统一的现状,因此仍需要进一步研究,为直肠癌患者术后肛门功能恢复曲线提供数据参考。

Objective To summarize the current commonly used anal function assessment methods after anorectal preservation surgery,and to discuss the current status of research and existing problems of anal function in patients after transanal total mesorectal excision(taTME)surgery.Method By searching the relevant literatures in domestic and international databases,the studies on anal function of patients after taTME and the studies on anal function assessment tools after anorectal preservation surgery were included to make an review.Results There was little literatures on the recovery of anal function after taTME,especially the long-term recovery of anal function after taTME was still unclear.The anal function in the early stage after traditional anal preserving operation for rectal cancer may be superior to taTME,but the recovery of anal function in the middle and long term after operation was similar.In terms of research tools,most of the current studies tend to use scale assessment method to describe the recovery of anal function after taTME,while the objective quantitative index,such as anorectal manometry and anal ultrasound were rarely used.Conclusion At present,there is a single and inconsistent research tool for the study of postoperative anal function after taTME,so further research is still needed to provide data reference for the postoperative anal function recovery curve of rectal cancer patients.