Anal function after ileocolonic interposition pouch in low anterior resection for rectal cancer patients

直肠癌患者低位前切除回结肠置袋术后肛门功能

• 批准号: 09671323
• 负责人: NAKAGOE Tohru
• 金额: $ 1.92万
• 依托单位: Nagasaki University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671323/
• 关键词: rectal cancer; ileocolonic interposition pouch; low anterior resction; 回盲部間置術

BACKGROUND/AIM : Ileocolonic interposition pouch (IIP) is a new candidate for pouch operation for rectal cancer patients, in which an ileocolonic segment is interposed between anal canal and descending colon after rectal cancer resection with total mesorectal excision. The aim of this study was to compare postoperative anal function utilizing IIP with those of the conventional straight type reconstruction (end-to-end sigmoid-anal canal anastomosis).PATIENTS AND METHODS : Seventeen rectal cancer patients who underwent IIP between 1995 and 200 were prospectively studied (IIP group). Twenty-six rectal caner patients who underwent conventional straight type reconstruction during same period served as the control group (Straight group). The operative outcomes, bowel movement, colonic transit time (using by SITZMARKS【○!R】), and manometric study between two groups were compared.RESULTS : The clinicopathological features of tumors and operative morbidity between two groups did not differ. Mean times of bowel movement at 1/3/6/12/24/36/48 month (s) after surgery is as follows : 9.4/6.3/5.6/4.7/3.9/ 3.2/3.7 (per day) in patients with IIP group and 11.6/7.6/6.4/5.1/4.1/3.9/4.5 (per day) in patients with Straight group, respectively. The mean (±standard deviation) of colonic transit time (half-dose) is as follows : 31.2 (±17.6) hours in patients with IIP group ; 65.1 (±38.8) hours in patients with Straight group ; 28.8 (±9.5) hours in healthy subjects. The manometric studies between two groups did not differ.CONCLUSION : The reconstruction using IIP may decrease the times of bowel movement and normalized the colonic transit time after surgery, forming an attractive alternative pouch operation in rectal cancer patients. The IIP may serve attractive features as follows : 1) preservation of nerve supply to pouch ; 2) no mobilization around the splenic flexure ; 3) intact pouch wall ; 4) no diversion.

背景/目的：回结肠插入袋（IIP）是直肠癌患者袋手术的新候选者，其中直肠癌全直肠系膜切除术后将回结肠段插入肛管和降结肠之间。本研究的目的是比较采用 IIP 的术后肛门功能与传统直型重建（端至端乙状结肠肛管吻合术）的术后肛门功能。 患者和方法：对 1995 年至 200 年间接受 IIP 的 17 名直肠癌患者进行前瞻性研究（IIP 组）。同期行常规直式重建术的26例直肠癌患者作为对照组（直式组）。比较两组的手术结果、排便情况、结肠传输时间（使用SITZMARKS【○！R】）和测压研究。结果：两组肿瘤的临床病理特征和手术发病率无差异。术后1/3/6/12/24/36/48个月的平均排便次数如下：IIP组患者分别为9.4/6.3/5.6/4.7/3.9/3.2/3.7（每天），Straight组患者分别为11.6/7.6/6.4/5.1/4.1/3.9/4.5（每天）。结肠传输时间（半剂量）的平均值（±标准差）如下：IIP组患者为31.2（±17.6）小时；直线组患者为 65.1 (±38.8) 小时；健康受试者为 28.8 (±9.5) 小时。两组之间的测压研究没有差异。结论：IIP重建可以减少术后排便次数并使结肠传输时间正常化，为直肠癌患者形成有吸引力的替代储袋手术。 IIP 具有如下吸引人的特点：1) 保留育儿袋的神经供应； 2) 脾曲周围无活动； 3）袋壁完好； 4）不改道。

项目成果

Tohru Nakagoe, Terumitsu Sawai, Takashi Tsuji, Nobuko Kurosaki, Hiroyoshi Ayabe: "A new pouch operation using ileocolonic interposition after low anterior resection for rectal cancer patients"Operation. 54. 1063-1068 (2000)

Tohru Nakagoe、Terumitsu Sawai、Takashi Tsuji、Nobuko Kurosaki、Hiroyoshi Ayabe：“直肠癌患者低位前切除术后使用回结肠介入的新储袋手术”手术。

Tohru Nakagoe, Terumitsu Sawai, Osamu Sasano, Hiroyuki Yamaguchi, Atsushi Nanashima, Toru Yasutake, Hiroyuki Kusano, Hiroyoshi Ayabe: "Ileocolonic interposition pouch in low anterior resection for rectal cancer patients"Operation. 50. 1903-1916 (1996)

Tohru Nakagoe、Terumitsu Sawai、Osamu Sasano、Hiroyuki Yamaguchi、Atsushi Nanashima、Toru Yasutake、Hiroyuki Kusano、Hiroyoshi Ayabe：“直肠癌患者低位前切除术中的回结肠插入袋”手术。

中越享: "直腸癌低位前方切除後の回結腸間置によるパウチ手術"手術. 54・8. 1063-1068 (2000)

Akira Nakagoshi：“直肠癌低位前切除术后回结肠介入术”外科手术54・8（2000）。