Liou Ching-Shiang, Chen Ching-Huey
Department of Nursing, National Cheng Kung University, R.O.C.
Hu Li Za Zhi. 2007 Aug;54(4):78-82.
In the past, Abdominal Perineal Resection (APR) with a permanent end-sigmoid colostomy was the major operating procedure for lower rectal cancer. Colostomy seriously affects patients' physical and psychological functions. Recently, the development of surgical devices and pre-operation adjuvant treatment combined with chemoradiotherapy have made an anal sphincter-preserving (ASP) operation possible. With these new treatment procedures, both the survival and recurrence rates are improved, as is patients' quality of life. The complications associated with ASP, however, are different from those associated with APR. There is only limited discussion of these issues in the literature on the subject. This paper synthesizes the information in the literature with the authors' personal clinical experiences. We propose several nursing interventions that could be applied by clinical nurses to assist ASP patients in coping with post-operative complications.
过去，腹会阴联合切除术（APR）加永久性乙状结肠造口术是低位直肠癌的主要手术方式。结肠造口严重影响患者的生理和心理功能。近年来，手术器械的发展以及术前辅助治疗与放化疗相结合，使得保留肛门括约肌（ASP）手术成为可能。采用这些新的治疗方法后，患者的生存率、复发率以及生活质量均得到了提高。然而，ASP相关的并发症与APR相关的并发症有所不同。关于这些问题，该领域的文献中仅有有限的讨论。本文将文献中的信息与作者的个人临床经验进行了综合。我们提出了几种护理干预措施，临床护士可应用这些措施来帮助ASP患者应对术后并发症。
