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目的比较结肠成形袋和结肠J型袋对改善直肠癌术后排便功能的作用。方法将73例中下段直肠癌随机分成两组,第1组(CPP组)36例,行结肠成形袋手术。第2组(CJP组) 37例,行结肠J型袋手术。分别于术后6、12个月对患者排便功能进行评价。结果CPP组均成功实施了结肠成形袋手术,但CJP组有4例(10％)因盆腔狭窄、肥胖未能成功实施结肠J形袋手术。术后6个月时两组每日平均排便次数为4．3和4．5,便后1 h内需再次排便为23％和20％,大便失禁评分为3和4。两组差异无统计学意义(t=0．384,X2=0．101,t=0．643,P>0．05)。术后12个月对每日平均便次、便后1 h内需再次排便、大便失禁等情况进行综合评分。CPP组和CJP组分别为: 2．4次、2．2次;5％、6％及2、3分。两组差异无统计学意义(t=0．419,X2=0．506,t=0．582,P>0．05)。结论结肠成形袋和结肠J型袋对改善直肠癌术后排便功能的作用相似。结肠成形袋方法简单、临床效果肯定,是一种很有前途的结肠贮袋手术。
Objective To compare the effect of colostomy bag and colon J-bag on defecation function after rectal cancer surgery. Methods Totally 73 cases of middle and lower rectal cancer were randomly divided into two groups. In group 1 (CPP group), 36 cases were treated with colostomy bag. Group 2 (CJP group) 37 cases underwent colon J-pocket surgery. The defecation function was evaluated at 6 and 12 months after operation. Results All patients underwent colostomy in the CPP group. However, 4 cases (10%) in the CJP group failed to complete colon J-bag surgery due to pelvic stenosis and obesity. At 6 months after operation, the average number of bowel movements per day was 4.3 and 4.5 in both groups, with re-defecation at 23% and 20% within 1 h, and fecal incontinence scores of 3 and 4, respectively. There was no significant difference between the two groups (t = 0.384, X2 = 0.101, t = 0.643, P> 0.05). After 12 months of the average number of times a day, then 1h re-defecation required within 1 hour, fecal incontinence and other comprehensive score. CPP group and CJP group were: 2.4 times, 2.2 times; 5%, 6% and 2,3 points. There was no significant difference between the two groups (t = 0.419, X2 = 0.506, t = 0.582, P> 0.05). Conclusions Colostomy bag and colon J-bag are effective in improving postoperative defecation function of rectal cancer. Colon forming bag method is simple, positive clinical results, is a promising colon pocket surgery.