Lu Bing, Fu Chuan-gang, Liu Lian-jie, Liu Yu-xiang, Xing Jun-jie, Meng Rong-gui, Jin Guo-xiang, Yu De-hong
Department of Colorectal Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2005 Nov;8(6):496-9.
To evaluate the bowel control of the anus-preserving operation for elderly patients over 75 years with low rectal cancer.
Thirty-nine elderly patients over 75 years with low rectal carcinoma (4-7 cm from anal verge) were treated during the study period. The patients were divided into different groups according to the surgical procedures and anastomotic locations. The bowel control and patients satisfaction were compared.
The time of recovering normal defecation frequency was (9.8+/- 2.9) months. There were no differences in bowel control and anorectal manometric findings between the lower anastomosis group and super-lower anastomosis group, the lower anastomosis group and anorectal anastomosis group. The patients in anorectal anastomosis group displayed significantly better bowel control and anorectal manometric findings than those in the super-lower anastomosis group (P< 0.05). The time of recovering normal defecation frequency in colonic J-pouch-anal anastomosis group was (7.7+/- 1.7) months, shorter than (10.6+/- 2.8) months in direct anastomosis group (P< 0.01). The complication rate of I degree incontinence was 36.1%, but there was no difference between the two groups. The anorectal manometric findings were better in J-pouch-anal anastomosis group than those in direct anastomosis group (P< 0.05).
Colonic J-pouch-anal anastomosis for lower rectal carcinoma can significantly improve the bowel control in a short term without increasing the complication rate.
评估75岁以上老年低位直肠癌患者保肛手术的排便控制情况。
在研究期间对39例75岁以上的低位直肠癌（距肛缘4 - 7厘米）患者进行治疗。根据手术方式和吻合部位将患者分为不同组，比较排便控制情况和患者满意度。
恢复正常排便频率的时间为（9.8±2.9）个月。低位吻合组与超低位吻合组、低位吻合组与直肠肛管吻合组之间在排便控制和直肠肛管测压结果方面无差异。直肠肛管吻合组患者的排便控制和直肠肛管测压结果明显优于超低位吻合组（P<0.05）。结肠J形贮袋肛管吻合组恢复正常排便频率的时间为（7.7±1.7）个月，短于直接吻合组的（10.6±2.8）个月（P<0.01）。Ⅰ度失禁的并发症发生率为36.1%，但两组之间无差异。J形贮袋肛管吻合组的直肠肛管测压结果优于直接吻合组（P<0.05）。
低位直肠癌行结肠J形贮袋肛管吻合术可在短期内显著改善排便控制，且不增加并发症发生率。
