改进五项联合术原位肛门整形重建的临床研究

摘要

目的 探讨低位直肠癌行Miles术同期行改进五项联合术原位肛门整形重建的方法和效果.方法 60例低位直肠癌患者行Miles术后,同期行改进五项联合术(肛门内括约肌、肛门外括约肌、直肠瓣、直肠角、肛门会阴部重建)原位人工肛门整形重建术.结果 本组患者术后5～6d即出现便意感,术后2～3周有自行控制排便意识,排便次数1～2次/d;经直肠内压测试,肛管静息压、缩窄压、直肠静息压、最大直肠内压等与正常对照组比较,差异均无统计学意义,术后5年以上远期生存率达88％.结论 低位直肠癌切除后即采用改进的五项联合术原位人工肛门整形重建,既可避免腹壁人工肛门的痛苦,又能提高患者的生活质量和远期生存率,减轻患者的经济负担.%Objective To study the effect of five combined operation for anus reconstruction after Miles operation in patients with lower colorectal cancer.Methods 60 patients with lower colorectal cancers received Miles operation,followed by five combined operation for anus reconstruction (internal and external anal sphincter,rectal flap,rectal angle,anus perineal reconstruction).Results 5-6 days after operation,all cases had desire to excretion.2-3 weeks lateral,all cases desired to control excretion and excreted 1 or 2 times per-day.Internal rectum testing showed the static pressure in anus,the constrictive pressure,and the static pressure in rectum were all normal.The survival rate of patients over 5 years was beyond 88％.Conclusions It suggests that five combined operation for anus reconstruction after Miles operation could avoid man-made anus on abdomen.It can improve the patients' life quality,long-term survival rate.And it's also economical method for patients.