Clinical and Physiological Factors Affecting Postoperative Anal Dysfunction After Low Anterior Resection for Rectal Cancer

直腸癌に対する低位前方切除術 (LAR) 後の, 排便機能障害の重症度に影響を及ぼす臨床的・生理学的因子を明らかにする目的で, 教室でLARを施行された22例に対して, 術前および術後5～7カ月に直腸肛門機能検査を施行した.術後排便機能障害の臨床的重症度は排便回数, soilingの有無と程度, 便意促迫の程度の3項目をスコア化して評価した。術後の排便機能は, 吻合部が肛門に近い例, 術後の直腸最大耐容量が小さい例で不良であった.臨床的因子および術前の直腸肛門機能検査の計測値を用いた重回帰分析により, 術後の排便障害の重症度は年齢, 吻合部の肛門縁からの距離, 術前の直腸最大耐容量, 術前の肛門管粘膜電流感覚閾値から予測できることが示された.LAR術後に排便機能障害が高度となることが予測される例に対しては, 直腸容量の増大を図ることが術後の排便機能障害の軽減に有効であることが示唆された.

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