DCR: 经肛与经腹全直肠系膜切除术后低位前切除综合征发生率的差异

2020-04-19 MedSci原创 MedSci原创

保留括约肌的手术方法的进步改善了直肠癌患者的生活质量。然而,他们中的许多人在手术后经历了包括低位前切除综合征在内的许多术后功能障碍。

背景及目的: 保留括约肌的手术方法的进步改善了直肠癌患者的生活质量。然而,他们中的许多人在手术后经历了包括低位前切除综合征在内的许多术后功能障碍。这项研究的目的是评估经肛门全直肠系膜切除后低位前切除综合征的严重程度,并将其与常规经腹,自上而下的全直肠系膜切除术进行比较。

方法: 这是一个单中心的回顾性分析。 该研究分析了2016年1月至2018年4月期间行低位直肠癌行全直肠系膜切除术的患者的临床数据。所测量的主要结局是手术或造口逆转后3、6和12个月的低位前切除综合征和粪便失禁的严重程度。

结果: 配对后每组35例。男性占67.1%,接受新辅助放疗的占41.4%。在3个月时,经肛门全直肠系膜切除后中位低位前切除综合征得分为37 ,显着高于常规方法32(p = 0.045)。除此之外,在6个月和12个月时,低位前切除综合征评分,严重程度分级和韦克斯纳评分相当。

结论: 在最初的三个月经肛门全直肠系膜切除后,观察到较高的低前切除综合征评分,但此后未观察到这种差异。这项研究表明,从长远来看,两种手术技术都具有相似的肛门和肠功能结局。

原始出处:

Foo, Chi Chung. Et al. Low Anterior Resection Syndrome After Transanal Total Mesorectal Excision: A Comparison With the Conventional Top-to-Bottom Approach. Diseases of the Colon & Rectum.2020.

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