ABSTRACT
Objective To study the effect of behavior-changes-in-stages theory on defecation function of lower rectal cancer after sphincter-preserving operation. Methods 84 patients with lower rectal cancer undergoing sphincter-preserving operation from June 2013 to June 2016 were divided into control group (n=42)and intervention group (n=42)according to their willingness to care.The control group implemented routine nursing,mainly for diet intervention,wound care,bowel function training and in the intervention group the behavior-changes-in-stages theory was used.Comparisons were done between the groups in terms of the anus incontinence defecation function and quality of life for 6 months after operation. Result The degrees of anus incontinence and defecation function in the intervention group were both significantly better than those in the control group 6 months after the operation (P<0.05). Conclusions The behavior-change-in-stages plays a significant role in the postoperative rehabilitation.It can significantly reduce the anus incontinence, better the bowel function,improve the quality of life and promote rehabilitation.
ABSTRACT
Objective To evaluate the influence of anus-preserved procedures on life quality of patients with low rectal carcinoma.Methods One hundred and forth cases with low rectal carcinoma who underwent double stapling technique(DST) (n =64) or support binding procedure(SBP) (n =50) were selected as our subjects.Patients in both group were undergone total mesorectal excision (TME) to sever mesorectum.Anal Function was assessed by Xu Zhongfa Anal-Function's criterion after operation.All patients were performed a 5 years follow-up.Results The 5-years survival rate and local recurrence rate were 65.63％ (37/64),20.03％ (13/64) respectively in DST group,and 76.0％ (38/50),6.0％ (3/50) in SBP group.The differences were significant (P =0.049,0.032).The postoperative general occurrence rate of dysuria,dysporia and sexual disorder in the DST group were 31.25％ (20/64),17.19％ (11/64) and 45.31％ (29/64) respectively,higher than those of SBP group(14.00％ (7/50),4.00％ (2/50) and 26.00％ (13/50) ;P =0.037,0.045,0.034).Conclusion Both DST and SBP therapy are proved to be effective in terms of anus-preserved treatment for low rectal cacinoma.5-year survival rate is similar in the two groups,while the survival quality is better in SBP group than in DST group.
ABSTRACT
Objective To study clinical therapeutic effects of anus-preserving operation with resecting anal intersphincter to treat ultra-low rectal cancer through abdominal cavity. Methods We retrospectively analyzed 52 cases of ultra-low rectal cancer, with the inferior border of the cancers within 2 cm to anocutaneous line or 5 cm to the edge of anus treated by anus-preserving operation with resecting archos internal sphincter muscles through abdominal cavity and anus. There were 29 males, and 23 females, with age 28 to 76 years old, averaging 56. 3 years old. The inferior border of the cancer were within 4 cm to the edge of anus in 18 cases, including 6 cases of adenoma cancerization, and 5 cm to the anus in 34 cases. Pathologic diagnosis was well-differentiated adenocarcinoma in 21 cases, moderately differentiated in 29 cases, low differentiated in 2 cases, there were 6 cases with adenoma cancerization. 28 cases were Dukes A stage, and 24 B stage. Results The follow-up rate was 88. 4% (46/52), and the median time was 5.9 years. 2 case developed stoma leak (3.8%), and 3 developed stoma stenosis(5.7% ) after operation. The anus could roughly control defecation in 6 ～ 12 mouths after operation. The local recurrence rate was 5.7%, and the 5-year-survival rate was 72.7%. Conclusion By anus-preserving operation with resecting archos internal sphincter muscles, defecation controlling was well reserved by anus, and the 5-year-survival rate was not cut down. This operation is one of the safe and effective operations of anus-preserving procedure.