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Functional outcome after low anterior resection for rectal cancer using the colonic J-pouch

使用结肠 J 型袋低位前切除直肠癌后的功能结果

基本信息

批准号：
07671436
负责人：
HIDA Jin-ichi
金额：
$ 1.41万
依托单位：
Kinki University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07671436/
关键词：
Rectal cancer Low anterior resection Colonic J-pouch reconstruction Lymph node metastases Evacuation difficulty Optimum pouch size J型結腸嚢再建の手術適応 J型結腸嚢排便機能 pouchgraphy

项目摘要

1.The functional outcome after low anterior resection (LAR) using the colonic J-pouch was compared with that after LAR using straight anastomosis. The functional outcome following LAR for rectal cancer is improved by the colonic J-pouch construction. 2.We tried to justify use of the sigmoid colon in the construction of a J-pouch by the analysis of regional lymph node metastases. Node metastases were examined by the clearing method. Metastatic rate of pericolic node was only 1.1 percent. Resection of sigmoid colon is not required, and therefore, a J-pouch can be constructed using the sigmoid colon. 3.Optimum size of this pouch has yet to be determined.We initiated a prospective, randomized trial using 5-cm (5J) and 10-cm (10J) pouches to determine this size. Clinical functions were evaluted using a functional scoring system. Reservoir function was evaluated by anorectal manometory and evacuation function by the balloon expulsion and saline evacuation tests. The functional score was similar for the two groups, although reservoir function in the 5-J group was significantly less than in the 10-J group. Evacuation function in the 5-J group was significantly superior to that in the 10-J group. The 5-cm J-pouch conferred adequate reservoir function without compromising evacuation.

1.比较采用结肠J形贮袋行低位前切除术（LAR）与采用直吻合行LAR后的功能结局。结肠J形贮袋结构改善了直肠癌LAR术后的功能结局。2.通过对区域淋巴结转移的分析，论证了乙状结肠在J-贮袋构建中的合理性。淋巴结转移采用透明法检查。结肠周围淋巴结转移率仅为1.1%。不需要切除乙状结肠，因此，可以使用乙状结肠构建J型袋。3.我们开始了一项前瞻性的随机试验，使用5 cm（5 J）和10 cm（10 J）的邮袋来确定这个尺寸。使用功能评分系统评价临床功能。通过肛门直肠测压评价贮器功能，通过球囊排出试验和生理盐水排空试验评价排空功能。两组的功能评分相似，尽管5-J组的储血功能显著低于10-J组。5-J组的排空功能明显优于10-J组的上级排空功能。5 cm J型袋具有足够的储液功能，且不影响排空。