Impact of Pelvic Radiotherapy on Morbidity and Durability of Sphincter Preservation After Coloanal Anastomosis for Rectal Cancers
Impact of Pelvic Radiotherapy on Morbidity and Durability of Sphincter Preservation After Coloanal Anastomosis for Rectal Cancers
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盆腔放射治疗对直肠癌结肠吻合术后保留括约肌的发病率和耐久性的影响
DOI：
10.1007/s10350-007-9099-x
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发表时间：
2008
影响因子：
3.9
通讯作者：
J. Pembérton
中科院分区：
文献类型：
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作者：
I. Hassan;D. Larson;B. Wolff;R. Cima;H. Chua;D. Hahnloser;M. O’byrne;D. Larson;J. Pembérton
目的：本研究的目的是评估盆腔放疗的影响，并发症的发生率和colostomy-free生存的患者后，结肠肛门吻合术直肠cancer.Methods：共192例进行了结肠肛门吻合术1982年至2001年：87例患者没有接受盆腔放疗，105例患者接受盆腔放疗（39术前和66术后）。早期和晚期的并发症，需要手术干预和结肠造口的生存率进行了评估，通过回顾性审查的患者records.Results：经过中位随访62个月，151例患者存活。最常见的并发症是吻合口狭窄（5年狭窄率为16%; 95%置信区间为10-21）。与未接受盆腔放疗的患者相比，接受盆腔放疗的患者有更高的并发症发生率，而不是吻合口狭窄，包括大便失禁，瘘，腹泻和肠梗阻（5年发生率：20%（95%置信区间，10-29）vs. 5%（95%置信区间，0-10）; P= 0.001）。接受盆腔放疗的患者的无结肠造口生存率低于未接受盆腔放疗的患者（5年无结肠造口生存率：72%（95%置信区间，62-84）vs. 92%（95%置信区间，86-98）; P< 0.001）。有没有显着差异，在结肠造口无生存的患者接受术前和术后盆腔radiotherapy.Conclusions：结肠肛门吻合术后，大量的患者将有并发症，需要手术干预，有些将需要永久性结肠造口。盆腔放疗，无论是术前还是术后，都显著增加了永久性结肠造口术的需要。
Purpose:This study was designed to assess the impact of pelvic radiotherapy on the incidence of complications and colostomy-free survival of patients after a coloanal anastomosis for rectal cancer.Methods:A total of 192 patients underwent a coloanal anastomosis between 1982 and 2001: 87 patients did not receive pelvic radiotherapy; 105 patients received pelvic radiotherapy (39 preoperative and 66 postoperative). Early and late complications requiring surgical intervention and the colostomy-free survival rate were assessed by retrospective review of patient records.Results:After a median follow-up of 62 months, 151 patients were alive. The most frequent complication was development of an anastomotic stricture (5-year rate of a stricture, 16 percent; 95 percent confidence interval, 10-21). Patients receiving pelvic radiotherapy had a higher rate of complications other than anastomotic strictures, including fecal incontinence, fistulas, abscesses, and bowel obstructions compared with patients not receiving pelvic radiotherapy (5-year rate: 20 percent (95 percent confidence interval, 10-29) vs. 5 percent (95 percent confidence interval, 0-10); P= 0.001). Patients receiving pelvic radiotherapy had a lower colostomy-free survival than did patients not receiving pelvic radiotherapy (5-year colostomy-free rate: 72 percent (95 percent confidence interval, 62-84) vs. 92 percent (95 percent confidence interval, 86-98); P< 0.001). There was no significant difference in the colostomy-free survival of patients receiving preoperative and postoperative pelvic radiotherapy.Conclusions:After coloanal anastomosis, a significant number of patients will have complications requiring surgical intervention, and some will require a permanent colostomy. Pelvic radiotherapy, whether it is administered preoperatively or postoperatively, significantly increases the need for a permanent colostomy.
直肠癌低位前切除术后 C01onic J 型袋与直吻合的长期功能结果比较：五年随访
DOI：
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发表时间：
2004
期刊：
Reprinted from Diseases of the Colon & Rectum 47(10)
影响因子：
--
作者：
Hiroshima K;Iyoda A;Shida T;Shibuya K;Iizasa T;Kishi H;Tanizawa T;Fujisawa T;Nakatani Y.;Hitoshi Shiozaki
通讯作者：
Hitoshi Shiozaki