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目的:评估延期手术对新辅助治疗后直肠肛门功能的影响。方法:回顾性分析43例直肠癌保肛根治术患者的临床资料,根据新辅助治疗与手术的间隔时间分为对照组(<8周)和延期组(>12周),测定两组术前及术后直肠静息压、肛管收缩压、直肠抑制反射和直肠感觉阈值。结果:术前直肠静息压延期组为(46.4±6.3)mm Hg,对照组为(42.3±5.7)mm Hg(P=0.03);术后6个月内直肠平均静息压延期组均高于对照组(P<0.05);1年后则两组差异无统计学意义(P=0.10)。术前肛门收缩压延期组与对照组分别为(176.4±21.3)mm Hg和(160.5±22.5)mm Hg(P=0.02),术后6个月内肛门收缩压延期组均高于对照组(P<0.01);1年后则两组差异无统计学意义(P=0.80)。直肠抑制反射两组术前、术后均无显著性差异。术后3、6个月直肠感觉阈值延期组均高于对照组(P<0.01)。结论:新辅助治疗后延期手术能改善患者术前和术后6个月内的直肠肛门功能。
Objective: To evaluate the effect of delayed surgery on rectal anorectal function after neoadjuvant therapy. Methods: The clinical data of 43 patients undergoing radical mastectomy for rectal cancer were retrospectively analyzed. According to the interval between neoadjuvant therapy and surgery, they were divided into control group (<8 weeks) and deferred group (> 12 weeks) And postoperative rectal resting pressure, anal canal systolic pressure, rectal suppressive reflex and rectal sensation threshold. Results: The preoperative rectal rest period was (46.4 ± 6.3) mm Hg in the control group and (42.3 ± 5.7) mm Hg in the control group (P = 0.03) In the control group (P <0.05). There was no significant difference between the two groups after one year (P = 0.10). The pre-anal ankle delamination and control groups were (176.4 ± 21.3) mm Hg and (160.5 ± 22.5) mm Hg, respectively (P = 0.02) P <0.01). After one year, there was no significant difference between the two groups (P = 0.80). Rectal suppression reflex in the two groups before and after surgery were no significant difference. The postoperative rectal sensation threshold was prolonged at 3 and 6 months after operation (P <0.01). Conclusion: Postoperative neoadjuvant surgery can improve the anorectal function in patients with preoperative and postoperative 6 months.