Kusunoki M, Shoji Y, Yanagi H, Kamikonya N, Sakanoue Y, Hishikawa Y, Utsunomiya J
Second Department of Surgery, Hyogo College of Medicine, Japan.
Br J Surg. 1993 Jul;80(7):933-5. doi: 10.1002/bjs.1800800749.
The effects of preoperative intraluminal brachytherapy on bowel function after anoabdominal rectal resection and colonic J pouch-anal anastomosis were studied. The patients included eight not receiving irradiation (group 1), eight who received 30 Gy (group 2) and eight who received 80 Gy (group 3). Stool frequency and the incidence of soiling were significantly greater in group 3 than in the other groups. Anal resting pressure was lower in group 3 during the study period but J pouch distensibility was not reduced. The maximum tolerated volume, threshold volume and squeeze pressure were significantly lower in group 3 than in the other groups in the early postoperative period. These results suggest that high-dose brachytherapy affects the anal sphincters and colonic J pouch. A moderate dose of 30 Gy may be more suitable before restorative anorectal surgery.
研究了术前腔内近距离放射治疗对腹会阴直肠癌切除及结肠J袋肛管吻合术后肠功能的影响。患者包括8例未接受放疗者（第1组）、8例接受30 Gy放疗者（第2组）和8例接受80 Gy放疗者（第3组）。第3组的排便频率和便污发生率显著高于其他组。在研究期间，第3组的肛门静息压较低，但J袋扩张性未降低。术后早期，第3组的最大耐受容量、阈容量和挤压压力显著低于其他组。这些结果表明，高剂量近距离放射治疗会影响肛门括约肌和结肠J袋。在进行修复性直肠肛管手术前，30 Gy的中等剂量可能更合适。
