低位直肠肛管癌行原位肛门重建术临床研究

The Clinical Study on the Orthotopic Anas Reconstruction for Low Anorectal Cancer

目的 :评价低位直肠肛管癌 (LAC)行原位肛门重建术 (OAR)的临床疗效。方法 :OAR(手术组 ) 2 0例行重建直肠瓣、直肠角 ,保留耻骨直肠肌和内外括约肌成形的重建术。术后观察控便功能 ,同时行肛肠测压 ,并与正常人 (对照组 ) 2 0例比较。结果 :术后 6个月 ,手术组肛门功能优良率达到 90 0 % ,肛管静息压 ,肛管最大挤压压 ,直肠顺应性与对照组比较无统计学意义 (P >0 0 5 )。结论 :OAR治疗LAC是一种可行的术式 。

Objective:To evaluate the clinical effect of the orthotopic anas reconstruction(OAR) for low anorectal cancer(LAC).Methods:Twenty patients with LAC were subjected to OAR,which contained rectal valves and rectal angle reconstruction,all or part of puborectal muscle preservation,internal and external sphincter plasty.After operation,the patients defecation function was observed,and anorectal pressure measurement was carried on.Results:Six months after operation,the anal defecation function was good(90.0%),there was no significant difference in the anal quiescent pressure,the maximal anal compressive pressure and the rectal compliance,compared OAR group with the control group(P>0.05).Conclusion:OAR is an effective operation for LAC,but it is necessary to select the operative indication strictly.