Ortiz H, De Miguel M, Armendáriz P, Rodriguez J, Chocarro C
Surgical Department, Virgen del Camino Hospital, Pamplona, Spain.
Dis Colon Rectum. 1995 Apr;38(4):375-7. doi: 10.1007/BF02054224.
Different studies have shown that low colorectal and coloanal anastomosis often yield poor functional results. The aim of the present study was to investigate whether a colonic reservoir is able to improve functional results.
Thirty-eight consecutive patients subjected to low anterior resection were randomized following rectal excision in two groups. One (n = 19) had a stapled straight coloanal anastomosis, and the other (n = 19) had a 10-cm stapled colonic pouch low rectal anastomosis. Median anastomotic distance above the anal verge was 3.38 +/- 0.56 cm and 2.14 +/- 0.36 cm in both groups, respectively. Continence alterations, urgency, tenesmus, defecatory frequency, anal resting and maximum voluntary squeezing pressures, and maximum tolerable volume were evaluated one year later.
One patient died of pulmonary embolism, and seven presented with a recurrence and were excluded from the study. Stool frequency was greater than three movements per day in 33.3 percent of cases with a reservoir and in 73.3 percent of those with a straight coloanal anastomosis (P < 0.05). Maximum tolerable volume was significantly greater in patients with a reservoir (335 +/- 195) than in those without (148 +/- 38) (P < 0.05). There were no significant differences in other variables studied.
This study shows that some aspects of defecatory function after rectal excision could improve with a colonic reservoir.
不同研究表明，低位结直肠和结肠肛管吻合术往往导致较差的功能结果。本研究的目的是调查结肠贮袋是否能够改善功能结果。
38例连续接受低位前切除术的患者在直肠切除术后被随机分为两组。一组（n = 19）进行吻合器直结肠肛管吻合术，另一组（n = 19）进行10 cm吻合器结肠袋低位直肠吻合术。两组患者吻合口距肛缘的中位距离分别为3.38±0.56 cm和2.14±0.36 cm。一年后评估控便改变、急迫感、里急后重、排便频率、肛门静息压和最大自主收缩压以及最大耐受容量。
1例患者死于肺栓塞，7例出现复发，被排除在研究之外。有结肠贮袋的患者中33.3%的病例每日排便次数超过3次，而进行直结肠肛管吻合术的患者中这一比例为73.3%（P < 0.05）。有结肠贮袋的患者最大耐受容量（335±195）显著大于没有结肠贮袋的患者（148±38）（P < 0.05）。在所研究的其他变量方面没有显著差异。
本研究表明，直肠切除术后排便功能的某些方面可通过结肠贮袋得到改善。
