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[直肠低位前切除术后的括约肌功能]

[Sphincter function after low anterior resection of the rectum].

作者信息

Pandolfo N, Ermili F, Ansaldo G L, Spigno L, Guiddo G, Romairone E, Mattioli F P

出版信息

Minerva Chir. 1989 Dec 31;44(23-24):2373-81.

PMID:2628792
Abstract

Until a few years ago, surgical technique and the age-old convictions of oncological radicality rejected very low rectal resections for cancer, particularly as the problem of postoperative incontinence did not exist. Currently, on the other hand, with the advent of mechanical staplers, the surgeon attempts increasingly to reconcile the possibility of using new sphincter-saving techniques with adequate oncological radicality, backed by accurate pre- and intraoperative staging. It is underlined that postoperative assessment of sphincter function in all its aspects, both clinical and instrumental, may be useful for the purpose of clarifying what anatomical structures should really be saved, delegated to retaining sphincter sensitivity and reflexes, so improving the functional results of operations. In addition, the almost rare identification of manifest or latent postoperative incontinence would make it possible to intervene in operated patients, for example by functional reeducation techniques as happens in the relatively recent biofeedback techniques.

摘要

直到几年前,外科技术以及肿瘤根治术由来已久的理念都不接受针对癌症的极低直肠切除术,尤其是当时不存在术后失禁问题。另一方面,目前随着机械吻合器的出现,外科医生越来越试图在准确的术前和术中分期支持下,将采用新的保留括约肌技术的可能性与足够的肿瘤根治性相协调。需要强调的是,对括约肌功能进行全面的术后临床和器械评估,对于明确真正应保留哪些解剖结构、赋予其保留括约肌敏感性和反射功能从而改善手术功能结果可能是有用的。此外,几乎很少发现明显或潜在的术后失禁情况,这将使我们能够对接受手术的患者进行干预,例如通过相对较新的生物反馈技术等功能再教育技术。

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