直肠癌低位前切除术后吻合口水平对肛门直肠功能的影响

目的 探讨吻合口水平对直肠癌低位前切除术后肛门直肠功能的影响.方法 连续观察直肠癌行低位前切除术患者33例,根据吻合口距肛缘的水平不同将患者分为：A 组（吻合口距肛缘≤4 cm） 18例,B组（吻合口距肛缘〉4 cm） 15例.结果 术后B组排便次数和控制排便时间明显优于A组,差异有统计学意义（P＜0.05）.两组直肠肛门抑制反射和肛管最大挤压压之间比较无明显差异.A组术后肛管最大静息压、直肠初感容量和最大耐受容量明显低于B组,差异有统计学意（P＜0.05）.结论 直肠癌低位前切除术后吻合口距肛缘≤4 cm患者的肛门直肠功能明显差于〉4 cm者.

Influence of anastomosis level on anorectal function outcomes following low anterior resection for rectal cancer

Objective To evaluate anorectal function results after low anterior resection for rectal cancer and to analyze the implication of level of the anastomosis in functions results. Methods Thirty - three consecutive patients who had undergone low anterior resection for rectal cancer were divided into 2 group depending on the level of the anastomosis above the anal verge. Group A （n = 18 ） ： shorter or equal to 4cm, and group B （ n = 15 ） ： longer than 4cm. Results Clinic function assessment showed that stool frequency increased and the a- bility to defer evacuation decreased in group B, which was obviously worse in group A after the operation. Manometry assessment showed that reetoanal inhibitory reflex revealed no significant difference between the two groups. Anal canal maximal resting pressure after operation showed a distinct decrease. Anal canal maximal squeeze pressure did not decrease significantly following the surgery. Rectum perception volume and maximum tolerable volume tended to be smaller in group A. Conclusion Anorectal function is influenced following low anterior resection for rectal cancer. If the level of anastomosis above the anal verge is expected to be below or equal to 4cm, there is much worse continence injury.