直肠癌的结肠肛管吻合术。梅奥诊所和克利夫兰诊所的长期结果。

Coloanal anastomosis for rectal cancer. Long-term results at the Mayo and Cleveland Clinics.

作者信息

Cavaliere F, Pemberton J H, Cosimelli M, Fazio V W, Beart R W

机构信息

Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Dis Colon Rectum. 1995 Aug;38(8):807-12. doi: 10.1007/BF02049837.

DOI:10.1007/BF02049837

PMID:7634975

Abstract

PURPOSE

This study was designed to determine functional outcomes and rates of survival and recurrence of coloanal anastomosis in rectal cancer patients.

METHODS

Between 1981 and 1991, 117 patients underwent coloanal anastomosis. Fifteen percent of the patients had a J-pouch; the rest had a straight coloanal anastomosis. Thirty-eight percent had no diverting stoma. Median distance of the tumor from the anal verge was 6.7 cm.

RESULTS

Local recurrence rate was 7 percent. Five-year survival was fully 69 percent. Satisfactory fecal continence was achieved by 78 percent of patients; no J-pouch patient had frequent incontinence. Sixty-two percent of the patients had major (anastomotic leak = 18 percent) or minor complications; complications were not mitigated by a diverting stoma or worsened by adjuvant therapy.

CONCLUSION

Although coloanal anastomosis is associated with a high chance of complications, the long-term outcome, in terms of disease-free survival and satisfactory function, is excellent.

摘要