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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.
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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.
RESUMO
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.