Evaluation of Anal Function in Patients with Rectal Carcinoma After Low Anastomosis Operation_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Zengrong , LI Ka , YING Yiqiong

Department of General Surgery, West China Hospital, Sichuan Uuniversity, Chengdu 610041, China;

Corresponding author：

Keywords：

Rectal carcinoma; Low anastomosis; Defecation function; Nursing

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Objective 　To evaluate anal function in patients with rectal carcinoma after low anastomosis operation.
Methods 　Five hundred and forty-one patients with low rectal carcinoma were followed up for 1-3 years to assess anal function after low or ultra-low Dixon anastomosis. The evaluation was based on Xu Zhong-fa Assessment Criteria of Anal Function, anastomotic position and time-to-operation. Defecation function training and rehabilitation instructions were administered after the operation.
Results 　The evaluation of defecation function showed that in the low Dixon operation group, 75.8%(211/278) scored “excellent”, 11.8%(33/278) scored “good”, 10.1%(28/278) scored “fair” and 2.2%(6/278) scored “poor”. In the ultra-low Dixon operation group, 70.7%(186/263) scored “excellent”, 13.3%(35/263) scored “good”, 10.6% (28/263) scored “fair”, and 5.3%(14/263) scored “poor”. No statistical difference was found between the low and ultra-low Dixon groups in this evaluation (Z= –1.429,P=0.136). However, there was statistical difference in the “awareness of defecation”(Z= –4.610,P=0.000) and “sense of defecation” (Z= –5.252, P=0.000) domains between the two groups. The defecation functions were similar between the low and the ultra-low Dixon operation groups after 6-month post-operation training(Z= –0.550, P=0.582).
Conclusions 　There is no difference in defecation function between low and ultra-low Dixon anastomotic operation patients with rectal carcinoma by nursing.

Citation： CHEN Zengrong,LI Ka,YING Yiqiong. Evaluation of Anal Function in Patients with Rectal Carcinoma After Low Anastomosis Operation. Chinese Journal of Evidence-Based Medicine, 2007, 07(3): 175-179. doi: Copy

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15.	张云杰. 拖出式Welch法超地位切除术治疗中下段直肠癌. 中国肛肠病杂志, 2001, 21(10): 15.
16.	郭澎, 张维平, 颜廷忠, 等. 经腹低位直肠癌切除结肠肛管吻合术的应用研究. 中华医学杂志, 2000, 80(6): 453.

1. Xu ZF, Zuo WS, Liu Q. Editor in chief. Modern Surgery for Rectal Tumor. 1st edition. Jinan: Shandong Science and Technology Press, 1993. 258–261.
2. Zhang QR. Clinical Anus-Large Intestine Surgery. 1st edition. Tianjing: Tianjing Science and Technology Translation and Publishing Corporation, 1991. 21.
3. Luo YS. Cause and treatment for postoperative local recurrence of rectal carcinoma. Chinese Journal of Coloproctology, 2002, 22(10): 21.
4. Zhang YJ. Pull-through Welch procedure in the ultralow resection for treating Low/Ultralow rectal carcinoma. Chinese Journal of Coloproctology, 2001, 21(10): 15.
5. Guo P, Zhang WP, Yan TZ, et al. A transabdominal-hiatal approach of anal canal anastomoses after resection of ultralow rectal carcinoma. Nat Med J Chin, 2000, 80(6): 453.
6. Vauthey JN, Marsh RW, Zlotecki RA, et al. Recent advances in the treatment and outcome of locally advanced rectal cancer. Ann Surg, 1999, 229(5): 745–752; discussion 752–754.
7. Andreola S, Leo E, Belli F, et al. Adenocarcinoma of the lower third of the rectum surgically treated with a <10-mm distal clearance: Preliminary results in 35_patients. Ann Surg Oncol, 2001, 8(7): 611–615.
8. Park YJ, Youk EG, Choi HS, et al. Experience of 1446 rectal cancer patients in Korea and analysis of prognostic factors. Int J Colorect Dis, 1999, 14(2): 101–106.
9. 徐忠发, 左文述, 刘奇. 主编. 现代肛肠肿瘤外科学. 第1版. 济南:山东科学技术出版社, 1993. 258~261.
10. 森田隆幸, 村田嘵彦, 小山基, 他. 直腸癌に对する門括筋機能温存手術. 消化器外科, 2003, 26: 327~334.
11. Parks AG. Pesection and suturd coloanal anastomosis for rdctal carcinoma. Br J Surg, 1982, 69(6): 301–304.
12. 张庆荣. 临床肛门大肠外科学. 第1版. 天津: 天津科技翻译出版公司, 1991. 21.
13. 佐治重丰, 车修次, 桥本俊幸. 直肠癌にする超低位直肠前方切除术.临床外科, 1993, 48(9): 1177~1779.
14. 罗运生. 直肠癌术后局部复发原因和治疗. 中国肛肠病杂志, 2002, 22(10): 21.
15. 张云杰. 拖出式Welch法超地位切除术治疗中下段直肠癌. 中国肛肠病杂志, 2001, 21(10): 15.
16. 郭澎, 张维平, 颜廷忠, 等. 经腹低位直肠癌切除结肠肛管吻合术的应用研究. 中华医学杂志, 2000, 80(6): 453.

Chinese Journal of Evidence-Based Medicine

Evaluation of Anal Function in Patients with Rectal Carcinoma After Low Anastomosis Operation

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