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論文(リポジトリ)

論文(リポジトリ)
島村, 公年 ; 畠山, 勝義 ; 須田, 武保 ; 酒井, 靖夫
出版情報: 新潟医学会雑誌 = 新潟医学会雑誌.  111  pp.142-146,  1997-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/44492
概要: Recently, function-preserving surgery has become more widely applied to patients with rectal cancer. Compared with abdom ioperineal resection, sphincter-saving procedure generally leads to an improved quality of life(QOL). However, straight colo-anal anastomsis(St type)for extremely low rectal carcinoma often causes a deterioration. Therefore, we have performed colonic J pouch-anal anastomosis(J type)since 1988. Forty patients who received the J type and 14 who received the St type are discussed. Mean daily stool frequency was 2.4 at 12 months after surgery in the J group, significantly lower than 5.0 in the St group. Frequent bowel movements and urgency placed restrictions on daily life in 29% of the St group, while there were no severe restrictions in the J group. An increased number of patients are undergoing autonomic nerve-preserving procedures, and good functional results have been obtained. The incidence of urinary dysfunction requiring consultation with a urologist was lower in the autonomic nerve-preserving group(3.4%)than in the non-preserving group(34.8%). Some sexual dysfunction was found in 14.3% of the autonomic nerve-preserving group, and in 92.3% of the non-preserving group. These results that the sphincter and autonomic nerve-preserving procedures produce good postoperative QOL. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
須田, 武保 ; 島村, 公年 ; 神田, 達夫 ; 岡本, 春彦 ; 酒井, 靖夫 ; 畠山, 勝義
出版情報: 新潟医学会雑誌 = 新潟医学会雑誌.  111  pp.1-6,  1997-01.  新潟医学会
本文リンク: http://hdl.handle.net/10191/44411
概要: The aim of this study was to investigate the curability of a sphincter-saving operation using a colonic J pouch-anal ana stomosis for lower rectal carcinoma and the postoperative result of urinary function after an autonomic nerve preservation procedure. Materials and methods:Forty-three patients who were treated with coloanal anastomosis, 33 of whom received the J type and 10 the straight type, were discussed. Results:The total rate of recurrence of rectal carcinoma(n=39)was 20.5%, with a 17.9% rate of distant metastasis and a pelvic recurrence rate of 2.6%, but no anastomotic recurrence. The five-year survival rate after curative resection was 84.3% in all cases. The incidence of neurogenic bladder was a lower rate in autonomic nerve preserving group(16.7%)than in autonomic nerve non-preserving group(53.8%). Conclusion:The sphincter-saving operation with colonic J pouch-anal anastomosis does not prejudice cure of this carcinoma. And the autonomic nerve preservation procedure was successful in minimizing urinary dysfunction. 続きを見る