直肠癌症低位前切除术患者吻合口关闭时机对低位前切除综合征的影响

Hemn H. Kaka Ali, Q. H. Abdulkarim, Karzan Seerwan, Barham M. M. Salih, Omar H. Ghalib Hawramy, Dara Ahmed Mohammed, Syamand Orhaman Ahmed
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引用次数: 0

摘要

这是一项多中心回顾性研究,对癌症低位前切除术患者进行了回顾性研究。回肠切开术是为了保护低位结肠直肠吻合术,一些患者由于患者自身意愿、手术并发症(吻合口瘘)或化疗粗糙而延迟了回肠造口术的闭合。本研究旨在发现临时回肠造口术对术后肠道功能减退的影响,这种功能被称为低位前切除综合征(LARS),包括:;紧迫感、排便困难、大便失禁和胀气。本研究共纳入50名患者,年龄从19岁到80岁不等,平均年龄为51.96岁。男性总人数为(33,%66)。大多数患者超重(21%,42%)。肿瘤距肛门边缘小于10cm者占31.62%。粪便转移的平均持续时间为7.17个月。回肠环形造瘘术在6个月前完成(27.54%)。未出现LARS的患者的平均转移持续时间为6.87个月,比出现LARS(7.31)的患者短。BMI较低的患者更容易出现LARS,而肥胖患者更容易发生严重的LARS。在6个月前关闭的患者回肠造口术中,19例出现LARS,在6个月中关闭的患者中,15例出现LARS。
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The impact of timing of stoma closure on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer
This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.    
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