Schibli M, Rittmann W W
Klinik für Chirurgie, Kantonsspital St. Gallen.
Helv Chir Acta. 1991 Jul;58(1-2):99-103.
Sphincter-saving operations are now generally accepted for the treatment of mid-rectal cancers. Different techniques have been described: low colorectal anastomosis with staplers, pull-through procedures and coloanal anastomosis. The functional results following these procedures are impaired by loss of the reservoir function of the rectum. To avoid frequency and urgency a J-shaped colonic reservoir is constructed and anastomosed to the anal canal. We are presenting our first four cases using this technique. All patients are personally reviewed 19-29 months after the operation. In correspondence with the literature all our patients had a good functional result with good continence and only one bowel movement per day. We conclude the creation of a neorectum makes the functional result of a coloanal anastomosis more predicable.
保留括约肌手术目前已被广泛接受用于治疗直肠中段癌。已描述了不同的技术:使用吻合器的低位结肠吻合术、拖出术和结肠肛管吻合术。这些手术之后的功能结果因直肠储袋功能丧失而受损。为避免出现尿频和尿急,构建一个J形结肠储袋并将其与肛管吻合。我们在此展示使用该技术的前四例病例。所有患者在术后19至29个月均接受了个人复查。与文献一致,我们所有患者的功能结果良好,控便能力良好,且每天仅排便一次。我们得出结论,新直肠的创建使结肠肛管吻合术的功能结果更可预测。