Schiessel R, Karner-Hanusch J, Herbst F, Teleky B, Wunderlich M
Department of Surgery, Donauspital im Sozialmedizinischen Zentrum Ost, Vienna, Austria.
Br J Surg. 1994 Sep;81(9):1376-8. doi: 10.1002/bjs.1800810944.
An abdominoperineal operation is described that extends rectal resection for low tumours into the intersphincteric plane with removal of the internal sphincter. Bowel continuity is restored by coloanal anastomosis. Of 38 patients who underwent surgery since 1984, 34 had low rectal cancer and four carcinoid or large villous adenoma. There was no mortality. Four patients developed local recurrence during a median observation period of 3 years. Continence was satisfactory in all patients. The median daily number of bowel movements during the first months after colostomy closure was 9 but decreased to 3 after 1 year and 1 after 2 years. Anal manometry demonstrated a significant reduction of mean resting pressure from 91.8 to 35.1 cmH2O with no recovery after 2 years (P < 0.0001). Squeeze pressure showed only a transient decrease.
描述了一种腹会阴手术，该手术将低位肿瘤的直肠切除术扩展至括约肌间平面，并切除内括约肌。通过结肠肛管吻合术恢复肠道连续性。自1984年以来接受手术的38例患者中，34例患有低位直肠癌，4例患有类癌或大绒毛状腺瘤。无死亡病例。在中位观察期3年期间，4例患者出现局部复发。所有患者的控便情况均令人满意。结肠造口关闭后最初几个月，每日排便次数中位数为9次，但1年后降至3次，2年后降至1次。肛门测压显示平均静息压力从91.8 cmH₂O显著降至35.1 cmH₂O，2年后未恢复（P < 0.0001）。挤压压力仅出现短暂下降。
