Colonic J pouch‐anal anastomosis after rectal excision for carcinoma: Functional outcome
Colonic J pouch‐anal anastomosis after rectal excision for carcinoma: Functional outcome
复制标题
直肠癌切除术后结肠 J 储袋肛管吻合术：功能结果
DOI：
10.1002/bjs.1800820513
复制
发表时间：
1995
影响因子：
9.6
通讯作者：
M. Humphreys
中科院分区：
文献类型：
--
作者：
N. Mortensen;J. M. Ramírez;N. Takeuchi;M. Humphreys
前瞻性研究了23例低位直肠癌患者（17例男性;平均年龄64.4（范围44 - 76）岁）行结肠J型贮袋-肛门吻合术的连续系列。从贮袋-肛门吻合到肛缘的平均距离为3.5（范围2.0 - 4.5）cm。在随访期间，1例患者死于无关原因，4例发生转移，2例局部转移和2例肝转移。在19名存活患者中，回肠造口术闭合后平均7个月的平均排便频率为每天2.1次（范围1.4次），5名患者有尿急，4名患者有轻度粪便渗漏，每周最多3次，7名患者有一定程度的不完全排空。在13例患者中，术前和术后的最大耐受容量或最大静息压无差异，但术后最大挤压压显著降低（术前和术后平均分别为189和132 cmH2O，P <0.05）。结肠袋重建术应被认为是行极低位前切除术患者直结肠肛管吻合术的替代方法。
A consecutive series of 23 patients with colonic J pouch‐anal anastomosis for low rectal cancer (17 men; mean age 64.4 (range 44–76) years) was studied prospectively. The mean distance from the pouch‐anal anastomosis to the anal verge was 3.5 (range 2.0–4.5) cm. During follow‐up one patient died from an unrelated cause and four developed metastases, two local and two hepatic. In 19 surviving patients a mean of 7 months after ileostomy closure mean bowel frequency was 2.1 (range 1.4) per day, five patients had urgency and four had mild faecal seepage up to three times per week, and seven patients had some degree of incomplete evacuation. In 13 patients there were no manometric differences before and after surgery with respect to maximum tolerated volume or maximum resting pressure, but maximum squeeze pressure was significantly lower after surgery (mean 189 versus 132 cmH2O before and after surgery respectively, P < 0.05). Colonic pouch reconstruction should be considered as an alternative to straight coloanal anastomosis in patients undergoing very low anterior resection.