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肛门内括约肌切除术后排便功能评估中 Fecoflowgram 的应用

Usefulness of Fecoflowgram for Assessment of Defecation after Intersphincteric Resection.

机构信息

Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.

Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.

出版信息

Digestion. 2018;98(2):81-86. doi: 10.1159/000487507. Epub 2018 Apr 26.

Abstract

AIM

We have developed an imaging functional assessment of defecation after partial intersphincteric resection (ISR) by fecoflowgram obtained by defecography.

PATIENTS AND METHODS

Between January 2012 and December 2014, 6 patients with temporary ileostomy who underwent partial ISR for lower rectal cancer at our hospital were enrolled in this study. Defecography was performed 2 weeks after closure of the ileostomy. The defecation of all patients was evaluated by defecography and a fecoflowgram calculated from defecography. During the same period, the control group was comprised of 2 male and 2 female healthy volunteers.

RESULTS

The descent of the perineum and linearization of the anorectal angle was observed relative to normal defecation in the healthy volunteers. All barium was discharged by a single abdominal pressure within 5 s in the controls. In patients after partial ISR, all barium could not be discharged by a single abdominal pressure. The time course of pressure distribution after ISR was lower than that of healthy volunteers, which could not be evaluated by defecography. Defecation time in patients following ISR was longer than that of healthy volunteers.

CONCLUSION

Fecoflowgrams calculated from defecography seem to be useful for functional assessment of defecation after rectal resection.

摘要

目的

我们通过排粪造影获得的排粪流率图,开发了一种用于评估经括约肌间切除术(ISR)后排便的影像学功能评估方法。

方法

2012 年 1 月至 2014 年 12 月,我院对 6 例因低位直肠癌而行暂时性回肠造口术的患者进行了部分 ISR 手术。在关闭回肠造口术 2 周后进行排粪造影。通过排粪造影和排粪造影计算的排粪流率图评估所有患者的排便情况。在此期间,对照组包括 2 名男性和 2 名女性健康志愿者。

结果

与健康志愿者正常排便相比,会阴下降和肛直角线性化。对照组所有钡剂均在 5 秒内通过单次腹部压力排出。在部分 ISR 术后患者中,所有钡剂均不能通过单次腹部压力排出。ISR 后压力分布的时间过程低于健康志愿者,无法通过排粪造影进行评估。ISR 术后患者的排便时间长于健康志愿者。

结论

排粪造影计算的排粪流率图似乎可用于评估直肠切除术后的排便功能。

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