Objective To assess the anal sphincteric function after intersphincteric resection for low rectal cancer by vectorial manometry. Methods Maximal anal pressure, vector volume, vector symmetric index and rectal anal inhibitory reflex were assessed in 16 patients underwent intersphincteric resection for low rectal cancer from 1999 to 2006. Thirty patients with low anterior resection for rectal cancer and another 30 healthy individuals were selected as control. Results The patients in intersphincteric resection group were subdivided into soiling group and defecation function good group. Maximal pressure, vector volume and vector symmetric index of the patients in soiling group and defecation function good group were significantly lower than those of the healthy and low anterior resection controls (P＜0.001). The maximal systole pressure, systole vector volume and vector symmetric index in soiling group were significantly lower than those in function good group (P＜0.001). The 25.0% patients in intersphincteric resection group had rectal anal inhibitory reflex， was significantly lower than that of the low anterior resection control group (93.3%, P＜0.001). Conclusion The maximal pressure and vector volume are compromised in patients underwent intersphincteric resection . The vectorial manometry can be an objective comprehensive tool for the evaluation of anal sphincter function in patients with intersphincteric resection.
目的 探讨低位直肠癌双吻合器保肛手术后吻合口漏的预防。 方法 回顾性分析2000年5月至2005年5月我院肛肠外科行双吻合器保肛手术的78例低位直肠癌患者的资料。结果 所有病例应用双吻合器进行直肠闭合并吻合成功,术后切缘病理检查均未见癌细胞浸润,无吻合口漏及手术死亡。随访73例(93.6%),随访时间9~65个月，平均35个月。盆腔复发2例(2.6%),腹腔广泛转移1例(1.3%),肝脏转移7例(9.0%),吻合口局部复发1例（1.3%,术后11个月再次行Miles术）。结论 双吻合技术为低位直肠癌患者提供更多的保肛机会,使用得当可有效预防吻合口漏的发生。