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目的探讨低位直肠癌保肛术后排便异常的原因以及相应处理方法。方法回顾性分析2005年1月—2009年12月98例低位直肠癌保肛术后患者出现排便异常的原因及治疗情况,并综合评价术后排便功能。结果 98例患者术后均出现排便异常。术后1个月排便次数5～7次/d,其中肛门括约肌功能不良:D级25.51%,E级5.10%。术后3个月排便次数3～5次/d,肛门括约肌功能不良:D级8.16%,患者排便不适,轻微疼痛。术后6个月排便次数1～2次/d,肛门括约肌功能:D级5.10%,患者排便不适,偶有刺痛;术后1年排便次数2～4次/d,基本接近正常,所有患者肛门括约肌功能介于A～C级,其中1例患者出现排便刺痛。结论低位直肠癌保肛术后排便异常多与术中处理相关,且经过后期治疗,排便异常可缓解,同时提高手术技巧可减少低位直肠癌术后排便异常,提高术后生活质量。
Objective To investigate the causes of defecation after anus-preserving operation in low rectal cancer and the corresponding treatment methods. Methods Retrospective analysis of the causes and treatment of abnormal defecation in 98 cases of low rectal cancer after anal sphincter preservation from January 2005 to December 2009 and the postoperative defecation function were evaluated. Results 98 cases of patients with abnormal bowel movements. The frequency of defecation was 5 ~ 7 times a day after operation, of which anal sphincter dysfunction was 25.51% in D grade and 5.10% in E grade. Defecation 3 to 5 times / d at 3 months after operation, anal sphincter dysfunction: Grade D 8.16%, patients with discomfort and slight pain. Dysfunction 6 months postoperatively 1 ~ 2 times / d, anal sphincter function: D 5.10%, patients with discomfort, occasional stinging; 1 postoperative defecation 2 to 4 times / d, basically close to normal, all Anal sphincter function in patients with A to C level, of which 1 case of stool defecation. CONCLUSIONS: Anorectal surgery is the most common cause of postoperative defecation in low rectal cancer, which is related to intraoperative management. After the treatment, the defecation abnormalities can be alleviated. At the same time, improving the surgical technique can reduce postoperative defecation abnormality and improve postoperative quality of life.