Objective To evaluate anal function in patients with rectal carcinoma after low anastomosis operation. Methods Five hundred and forty-one patients with low rectal carcinoma were followed up for 1-3 years to assess anal function after low or ultra-low Dixon anastomosis. The evaluation was based on Xu Zhong-fa Assessment Criteria of Anal Function, anastomotic position and time-to-operation. Defecation function training and rehabilitation instructions were administered after the operation. Results The evaluation of defecation function showed that in the low Dixon operation group, 75.8%(211/278) scored “excellent”, 11.8%(33/278) scored “good”, 10.1%(28/278) scored “fair” and 2.2%(6/278) scored “poor”. In the ultra-low Dixon operation group, 70.7%(186/263) scored “excellent”, 13.3%(35/263) scored “good”, 10.6% (28/263) scored “fair”, and 5.3%(14/263) scored “poor”. No statistical difference was found between the low and ultra-low Dixon groups in this evaluation (Z= –1.429,P=0.136). However, there was statistical difference in the “awareness of defecation”(Z= –4.610,P=0.000) and “sense of defecation” (Z= –5.252, P=0.000) domains between the two groups. The defecation functions were similar between the low and the ultra-low Dixon operation groups after 6-month post-operation training(Z= –0.550, P=0.582). Conclusions There is no difference in defecation function between low and ultra-low Dixon anastomotic operation patients with rectal carcinoma by nursing.
Objective To study the relationship between autonomic nerve preservation and sexual and urinary functions after total mesorectal excision in patients with cancer of the lower rectum, and to explore improved nursing methods for these patients. Methods Eligible patients with cancer of the lower rectum were non-randomly assigned to either a control group (n=278)or an autonomic nerve-preserving group （n=263）. The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were observed. Results The recovery time of micturition desire, catherization time, lower urinary tract infection rate, residual urine, severity of urinary disorders and sexual disorders were lower in the autonomic nerve-preserving group than in the control group. (Plt;0.05) . Conclusion Autonomic nerve preservation radical resection leads to better maintenance of urinary and sexual functions for patients with cancer of the lower rectum. Nursing should be focused on the prevention of urinary tract complications and the rehabilitation of sexual and urinary functions.
Objective To compare the clinical effect between alginate calcium dressing and radix yarn dressing after anal fistula surgery. Methods A survey of 128 patients with anal fistula from April to October 2008 were studied. Patients were divided into two groups using a simple random method: 64 cases in therapy group which were treated with alginate calcium dressing and 64 cases in control group which were treated with traditional radix yarn dressing. The difference of the wound recovery indexes between two groups was compared.Results With regard to age, gender, anal fistula type, the proportion of preoperative diabetes and the diameter of wound, there was no statistical significance between therapy group and control group (Pgt;0.05). The proportion of slight pain during dressing change in therapy group (45.32%, 29/64) was more than control group (25.00%, 16/64), which had statistical significance (Pgt;0.05). The incidence of skin allergy was significantly different between two groups (29.69% vs. 60.94%, P＜0.05). Also, the rotten tissue and the soakage disappears with a shorter period, which both had statistical significance 〔(8.60±2.37) d vs. (12.22±3.29) d， (16.96±5.83) d vs. (22.02±5.90) d〕， Plt;0.05.Conclusion With the shorten of inflammatory and increment stage of the wound recovery, alginate calcium dressing is an ideal material for the postoperative duration of surgery of anal fistula.
Objective To explore the quality of life of colorectal cancer patients undergoing multi-disciplinary comprehensive treatment by neo-adjuvant chemotherapy combined with radical resection. Methods From May 2007 to August 2007, the patients diagnosed definitely as colorectal cancer were analyzed retrospectively, of whom accepted neo-adjuvant chemotherapy combined with surgery were included and evaluated by quality of life questionnaire-core 30 (QLQ-C30) of European Organization for Research and Treatment of Cancer (EORTC), and there were 3 time points chosen for assessment which were pre-neoadjuvant chemotherapy stage (point A), preoperative stage after neo-adjuvant chemotherapy (point B), and one month after surgery (point C). Results A total of 57 patients with an average age of 56.33 years (41-69 years) were incorporated in this study, and among which there were 34 male and 23 female; and 10 right-sided hemi-colonic cancer, 4 left sided hemi-colonic cancer, 43 rectal cancer. The global health differences between the A and B point or A and C point were statistically significant (Plt;0.001) whereas no significant difference existed between B and C point (Pgt;0.05). For the functioning scales of physical, physical, role, cognitive, and social function, no statistically difference among A, B and C time point. Although there wasn’t any emotional difference existed between A and B point (Pgt;0.05), obvious differ between C and A or C and B point were showed out (Plt;0.005). And for symptom scales, no remarkable differences came out among A, B and C point for dyspnoea and constipation (Pgt;0.05); reversely, great differences were found for fatigue, pain, insomnia, appetite loss, and diarrhoea between C and A or C and B point (Plt;0.01), but nope for A and B in the 5 items of symptom (Pgt;0.05). And the score of nausea and vomiting presented significantly differences between A and B or B and C point (Plt;0.01), but nope for A and C in this item (Pgt;0.05). There came out distinct significantly for financial impact among A, B and C point with a worsen score from early to late stage (Plt;0.001). Conclusion The intervention of chemotherapy could worsen the quality of life during the treatment of neo-adjuvant chemotherapy combined with surgery which may be attributed to the side reaction, but such adverse reaction may not affect actually the postoperative subjective feeling; On the other hand, the colorectal surgery may not decrease the quality of life although which could lead more early postoperative uncomforting. However, it needs more researches to discuss about the contribution of different comprehensive treatment strategy to the quality of life as well as the cost-effective analysis.