Study of shift mechanism of bowel control after laparoscopic intersphincteric resection for ultra-low rectal carcinoma

doi:10.3877/cma.j.issn.1674-0793.2018.03.012

Abstract

Abstract:

Objective

To explore the regularity of bowel control after laparoscopic intersphincteric resection (ISR) for ultra-low rectal cancer.

Methods

Between June 2014 and June 2016, twenty nine patients with laparoscopic ISR for ultra-low rectal cancer were selected as the study objects (experimental group). The Wexner score of anal incontinence, anorectal manometry and the resting volume determination of rectum were used to evaluate anal function in experimental group and control group (healthy adults) at 1, 3, 6, 12 months after operation.

Results

Experimental group and control group were significantly different 1, 3, 6, 12 months after the operation by the Wexner incontinence score (P<0.01). In experimental group, 3 months vs 1 month and 6 months vs 3 months and 12 months vs 6 months after operation were significantly different (F=182.4, P<0.001). Experimental group and control group were significantly different 1, 3, 6 months after the operation by anorectal manometry (P<0.05). In experimental group, 3 months vs 1 month and 6 months vs 3 months and 12 months vs 6 months after operation were significantly different by Maximum resting pressure (F=25.029, P<0.05). Experimental group and control group were significantly different 1, 3, 6, 12 months after the operation by resting volume determination of rectum (all P<0.001). In experimental group, 3 months vs 1 month and 6 months vs 3 months and 12 months vs 6 months after operation were significantly different (F=4 640.715, 3 421.403, both P<0.001).

Conclusion

Anal continence is a gradual recovery process for patients with lower rectal cancer undergoing resection of the sphincter, which can reach or close to normal level one year after surgery.

Key words: Rectal neoplasms, Sphincterotomy, endoscopic, Anal continence, Ultra-low

Zhigang Guo, Shihai Zhou, Hong Chen, Yao Wang, Hongzhi Luo, Chunzai Feng, Huizhou Deng, Zhifeng Yang, Jiyan Li. Study of shift mechanism of bowel control after laparoscopic intersphincteric resection for ultra-low rectal carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(03): 200-203.

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References 15

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组别		肛门失禁Wexner评分	t值^a	P值^a
对照组		0.24±0.13
治疗组
	术后1个月	11.28±2.83	21.1	<0.001
	术后3个月	5.72±1.96	15.0	<0.001
	术后6个月	4.69±1.23	19.6	<0.001
	术后12个月	0.45±0.36	3.37	0.002

组别		肛门失禁Wexner评分	t值^a	P值^a
对照组		0.24±0.13
治疗组
	术后1个月	11.28±2.83	21.1	<0.001
	术后3个月	5.72±1.96	15.0	<0.001
	术后6个月	4.69±1.23	19.6	<0.001
	术后12个月	0.45±0.36	3.37	0.002

组别		最大静息压(mmHg)	t值^a	P值^a	最大收缩压(mmHg)	t值^a	P值^a
对照组		52.15±12.33			117.27±26.27
治疗组
	术后1个月	22.24±7.12^a	9.764	<0.001	76.26±23.54^a	6.162	<0.001
	术后3个月	33.52±12.07^a,b	5.156	<0.001	89.45±24.77^a,b	4.258	<0.001
	术后6个月	38.41±15.30^a,b	3.184	0.002	94.66±31.97^a,b	2.541	0.014
	术后12个月	46.35±18.45^b	0.428	0.670	104.17±31.25^b	1.419	0.161
组别		静息向量容积[cm×(cmHg)²]	t值^a	P值^a	收缩向量容积[cm×(cmHg)²]	t值^a	P值^a
对照组		588.9±24.67			891.6±39.92
治疗组
	术后1个月	89.55±25.18^a	76.862	<0.001	123.1±42.31^a	72.767	<0.001
	术后3个月	175.34±34.54^a,b	54.305	<0.001	273.3±53.55^a,b	52.221	<0.001
	术后6个月	248.53±42.12^a,b	32.001	<0.001	384.3±64.94^a,b	35.098	<0.001
	术后12个月	356.83±44.26^a,b	25.616	<0.001	576.6±69.52^a,b	22.299	<0.001

组别		最大静息压(mmHg)	t值^a	P值^a	最大收缩压(mmHg)	t值^a	P值^a
对照组		52.15±12.33			117.27±26.27
治疗组
	术后1个月	22.24±7.12^a	9.764	<0.001	76.26±23.54^a	6.162	<0.001
	术后3个月	33.52±12.07^a,b	5.156	<0.001	89.45±24.77^a,b	4.258	<0.001
	术后6个月	38.41±15.30^a,b	3.184	0.002	94.66±31.97^a,b	2.541	0.014
	术后12个月	46.35±18.45^b	0.428	0.670	104.17±31.25^b	1.419	0.161
组别		静息向量容积[cm×(cmHg)²]	t值^a	P值^a	收缩向量容积[cm×(cmHg)²]	t值^a	P值^a
对照组		588.9±24.67			891.6±39.92
治疗组
	术后1个月	89.55±25.18^a	76.862	<0.001	123.1±42.31^a	72.767	<0.001
	术后3个月	175.34±34.54^a,b	54.305	<0.001	273.3±53.55^a,b	52.221	<0.001
	术后6个月	248.53±42.12^a,b	32.001	<0.001	384.3±64.94^a,b	35.098	<0.001
	术后12个月	356.83±44.26^a,b	25.616	<0.001	576.6±69.52^a,b	22.299	<0.001

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