BACKGROUND From the anal function,inflammatory response and other indicators,acupuncture combined with rehabilitation gymnastics was applied to patients with cancer undergoing low resection,aiming to improve the progn...BACKGROUND From the anal function,inflammatory response and other indicators,acupuncture combined with rehabilitation gymnastics was applied to patients with cancer undergoing low resection,aiming to improve the prognosis of patients.AIM To explore the effects of acupuncture combined with rehabilitation gymnastics on anal function after lower rectal cancer surgery.METHODS From January 2020 to December 2022,128 patients who underwent rectal cancer surgery in the Department of Oncology of Hebei Provincial Hospital of Traditional Chinese Medicine Hospital were selected and divided into two groups using the random number table method,with 64 patients in each group.Patients in the control group were not treated with acupuncture or rehabilitation gymnastics and served as blank controls.Patients in the study group were treated with acupuncture and rehabilitation gymnastics from the 7th postoperative day.The anal incontinence scores,changes in serum interleukin-4,interleukin-6,and interleukin-10 Levels,and serum motilin,5-hydroxytryptamine,and vasoactive intestinal peptide levels were compared.RESULTS There were no significant differences in serum interleukin-4,interleukin-6,and interleukin-10 Levels between the groups before treatment(P>0.05).After treatment,these levels were better than those of the control group(P<0.05).There was no significant difference in the anal incontinence scores between the groups before and 7 d after surgery(P>0.05).Anal incontinence scores in the study group were lower than those in the control group at 14 d,21 d,and 28 d postoperatively(P<0.05).There were no significant differences in serum motilin,5-hydroxytryptamine,or vasoactive intestinal peptide levels between the groups before treatment(P>0.05).After treatment,these levels were higher in the study group than in the control group,and vasoactive intestinal peptide level was lower in the study group than in the control group(P<0.05).CONCLUSION Acupuncture combined with rehabilitation gymnastics can promote the recovery of anal function and reduce the inflammatory response in patients with lower rectal cancer after surgery.展开更多
BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To e...BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.METHODS From the anorectal surgery cases,we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group(n=60),observation group(n=60),and control group after surgery for lifestyle intervention(including smoking cessation and exercise),dietary factor adjustment,anal movement,and oral loperamide treatment.The serum levels of motilin,5-hydroxytryptamine,and vasoactive intestinal peptide(VIP),Wexner score for anal incontinence,and incidence of complications were compared between groups.RESULTS After treatment,the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group(P<0.05).The motilin level was higher than that in the control group(P<0.05).Postoperative anal incontinence was better in the observation group than in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that in the control group(21.67%;P<0.05).CONCLUSION Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery;it can effectively help to improve the serum indices of patients,avoid the occurrence of anal incontinence,and reduce the incidence of complications.Popularizing and applying it will be valuable.展开更多
Objective： To assess the anal sphincter function after intersphincteric resection for low rectal cancer by questionnaire and vectorial manometry. Methods： twenty five patients underwent intersphincteric resection, t...Objective： To assess the anal sphincter function after intersphincteric resection for low rectal cancer by questionnaire and vectorial manometry. Methods： twenty five patients underwent intersphincteric resection, the controls contained 25 patients of rectal cancer who underwent low anterior resection and 25 healthy people. The therapeutic responses were evaluated using the Vaizey and Wexner scoring systems and vectorial manometry. Results： The Vaizey and Wexner scores after intersphincteric resection were significantly higher than those of low anterior resection controls at one month, but had no significant difference one year after. On the other hand, the indexes of vectorial manometry still had significant difference one year later. The indexes after intersphincteric resection could not reach the normal level. Conclusion： The anal sphincter function after intersphincteric resection is lower than that after low anterior resection in short term, although the long-term results can be accepted, it still can not reach the normal level.展开更多
Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a no...Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a non-randomized prospective observational cohort study. Inclusion of the study was done at the University Hospital, Uppsala, Sweden, between 2002 and 2007. Thirty-nine consecutive female patients admitted for anal sphincter repair were invited to the study. Twenty patients accepted and were included, four were lost to follow up and one was unevaluable (due to the formation of a stoma) leaving a study group of 15 patients. The patients were assessed with questionnaires before surgery and at three and 12 months after surgery. Outcomes: Change in reported sexual activity and dyspareunia. Results: Before surgery, 12/15 patients reported that their sexual life was impaired due to anal incontinence. The corresponding figure at 12 months was 9/15 (p = 0.43). Three patients remained sexually inactive throughout the study, five patients increased their sexual activity and one had decreased activity. Out of the 12 who were active, four stated dyspareunia at baseline, and only one reported dyspareunia at 12 months. The mean Miller incontinence scores at baseline and 12 months were 10.1 and 8.7, respectively. The change in incontinence score did not differ between those with decreased, stable or increased sexual activity. However, there was a definite correlation (r = 0.54 - 0.60, p 0.05) between change in sexual function and deferring time for stool. Clinical Implications: Operative management of anal sphincter tears alone is not curative for sexual problems due to anal incontinence but can be a part of the treatment. Strengths and Limitations: The study is a prospective study of sexual function. The limitations are that the questionnaires were not validated due to lack of such questionnaires at the time of the study and that the study population is quite small. Conclusion: Patients with a sphincter injury and fecal incontinence often have an impaired sexual function. Increased deferring time for stools after surgery increases the likelihood of improved sexual function.展开更多
BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures ...BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring.Postoperative loss of anal function can cause physical and mental damage.Transanal opening of the intersphincteric space(TROPIS)is an effective procedure that completely preserves the external anal sphincter.However,its clinical application is limited by challenges in the localization of the internal opening of a fistula and the high risk of complications.On the basis of our clinical experience,we modified the TROPIS procedure for the treatment of treating high complex anal fistulas.CASE SUMMARY A patient with a high complex anal fistula located above the anorectal ring underwent modified TROPIS,which involved sepsis drainage and identification of the internal opening in the intersphincteric space.The patient with the high complex anal fistula recovered well postoperatively,without any postoperative complications or anal dysfunction.Anal function returned to normal after 17 months of follow-up.CONCLUSION The modified TROPIS procedure is the most minimally invasive surgery for anal fistulas that minimally impairs anal function.It allows the complete removal of infected anal glands and reduces the risk of postoperative complications.Modified TROPIS via the intersphincteric approach is an alternative sphincter-preserving treatment for high complex anal fistulas.展开更多
目的探究三间隙引流术对高位肛周脓肿病人肛门功能、创面愈合及血清激活素A(ACTA)水平的影响。方法纳入西北大学第一医院2020年10月至2022年10月收治的48例高位肛周脓肿病人,依照治疗方案分为研究组和对照组,各24例。对照组病人行传统...目的探究三间隙引流术对高位肛周脓肿病人肛门功能、创面愈合及血清激活素A(ACTA)水平的影响。方法纳入西北大学第一医院2020年10月至2022年10月收治的48例高位肛周脓肿病人,依照治疗方案分为研究组和对照组,各24例。对照组病人行传统切开引流术,研究组行三间隙引流术。比较两组病人创面愈合时间、住院时间、术后视觉模拟评分法(VAS)评分及术后肛门功能;比较两组病人手术前后血清炎症因子、疼痛因子及ACTA水平变化。结果研究组术后创口愈合时间[(18.25±2.36)d比(22.25±3.12)d]、住院时间均较对照组缩短(均P<0.05);研究组术后7 d VAS评分低于对照组(P<0.05)。协方差主体间效应检验显示,研究组病人血清5-羟色胺(5-HT)、去甲肾上腺素(NE)水平较对照组降低(均P<0.05);术后7 d研究组Wexner量表评分[(7.07±0.97)分比(9.47±1.49)分]低于对照组(P<0.05)。术后7 d研究组血清白细胞介素(IL)-1β、C反应蛋白(CRP)、IL-6、肿瘤坏死因子α(TNF-α)、ACTA[(8.07±1.07)μg/L比(13.08±1.07)μg/L]水平较对照组降低(均P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论三间隙引流术创面小,可有效缓解病人疼痛,减轻炎症反应,降低ACTA水平及相关并发症发生率,保留肛门功能,改善病人术后生活质量。展开更多
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi...BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.展开更多
基金Supported by The Government Subsidizes Special Funds for Outstanding Health Talents,No.Ji Cai Yu Fu[2020]397.
文摘BACKGROUND From the anal function,inflammatory response and other indicators,acupuncture combined with rehabilitation gymnastics was applied to patients with cancer undergoing low resection,aiming to improve the prognosis of patients.AIM To explore the effects of acupuncture combined with rehabilitation gymnastics on anal function after lower rectal cancer surgery.METHODS From January 2020 to December 2022,128 patients who underwent rectal cancer surgery in the Department of Oncology of Hebei Provincial Hospital of Traditional Chinese Medicine Hospital were selected and divided into two groups using the random number table method,with 64 patients in each group.Patients in the control group were not treated with acupuncture or rehabilitation gymnastics and served as blank controls.Patients in the study group were treated with acupuncture and rehabilitation gymnastics from the 7th postoperative day.The anal incontinence scores,changes in serum interleukin-4,interleukin-6,and interleukin-10 Levels,and serum motilin,5-hydroxytryptamine,and vasoactive intestinal peptide levels were compared.RESULTS There were no significant differences in serum interleukin-4,interleukin-6,and interleukin-10 Levels between the groups before treatment(P>0.05).After treatment,these levels were better than those of the control group(P<0.05).There was no significant difference in the anal incontinence scores between the groups before and 7 d after surgery(P>0.05).Anal incontinence scores in the study group were lower than those in the control group at 14 d,21 d,and 28 d postoperatively(P<0.05).There were no significant differences in serum motilin,5-hydroxytryptamine,or vasoactive intestinal peptide levels between the groups before treatment(P>0.05).After treatment,these levels were higher in the study group than in the control group,and vasoactive intestinal peptide level was lower in the study group than in the control group(P<0.05).CONCLUSION Acupuncture combined with rehabilitation gymnastics can promote the recovery of anal function and reduce the inflammatory response in patients with lower rectal cancer after surgery.
基金Supported by the Government Subsidizes Special Funds for Outstanding Health Talents,No.0700000042.
文摘BACKGROUND According to the indexes of serum and anal function,acupuncture therapy was applied to patients with low rectal cancer in order to avoid the occurrence of anal incontinence and reduce complications.AIM To explore the clinical application and evaluate the effect of acupuncture therapy for anal function rehabilitation after low-tension rectal cancer surgery.METHODS From the anorectal surgery cases,we selected 120 patients who underwent colorectal cancer surgery between January 2020 and December 2022 and randomly divided them into a control group(n=60),observation group(n=60),and control group after surgery for lifestyle intervention(including smoking cessation and exercise),dietary factor adjustment,anal movement,and oral loperamide treatment.The serum levels of motilin,5-hydroxytryptamine,and vasoactive intestinal peptide(VIP),Wexner score for anal incontinence,and incidence of complications were compared between groups.RESULTS After treatment,the VIP and 5-hydroxytryptamine levels in the observation group were lower than those in the control group(P<0.05).The motilin level was higher than that in the control group(P<0.05).Postoperative anal incontinence was better in the observation group than in the control group(P<0.05).The incidence of complications in the observation group was 6.67%,which was significantly lower than that in the control group(21.67%;P<0.05).CONCLUSION Acupuncture therapy has a positive effect on the rehabilitation of anal function after low-tension rectal cancer surgery;it can effectively help to improve the serum indices of patients,avoid the occurrence of anal incontinence,and reduce the incidence of complications.Popularizing and applying it will be valuable.
基金This work was supported by a grant from the Education Department of Liaoning Province(No.05L484).
文摘Objective： To assess the anal sphincter function after intersphincteric resection for low rectal cancer by questionnaire and vectorial manometry. Methods： twenty five patients underwent intersphincteric resection, the controls contained 25 patients of rectal cancer who underwent low anterior resection and 25 healthy people. The therapeutic responses were evaluated using the Vaizey and Wexner scoring systems and vectorial manometry. Results： The Vaizey and Wexner scores after intersphincteric resection were significantly higher than those of low anterior resection controls at one month, but had no significant difference one year after. On the other hand, the indexes of vectorial manometry still had significant difference one year later. The indexes after intersphincteric resection could not reach the normal level. Conclusion： The anal sphincter function after intersphincteric resection is lower than that after low anterior resection in short term, although the long-term results can be accepted, it still can not reach the normal level.
文摘Background: Many women suffer from sexual problems after anal sphincter tears due to obstetric trauma. Aim: The study aimed to assess changes in sexual function after anal sphincter repair. Methods: The study was a non-randomized prospective observational cohort study. Inclusion of the study was done at the University Hospital, Uppsala, Sweden, between 2002 and 2007. Thirty-nine consecutive female patients admitted for anal sphincter repair were invited to the study. Twenty patients accepted and were included, four were lost to follow up and one was unevaluable (due to the formation of a stoma) leaving a study group of 15 patients. The patients were assessed with questionnaires before surgery and at three and 12 months after surgery. Outcomes: Change in reported sexual activity and dyspareunia. Results: Before surgery, 12/15 patients reported that their sexual life was impaired due to anal incontinence. The corresponding figure at 12 months was 9/15 (p = 0.43). Three patients remained sexually inactive throughout the study, five patients increased their sexual activity and one had decreased activity. Out of the 12 who were active, four stated dyspareunia at baseline, and only one reported dyspareunia at 12 months. The mean Miller incontinence scores at baseline and 12 months were 10.1 and 8.7, respectively. The change in incontinence score did not differ between those with decreased, stable or increased sexual activity. However, there was a definite correlation (r = 0.54 - 0.60, p 0.05) between change in sexual function and deferring time for stool. Clinical Implications: Operative management of anal sphincter tears alone is not curative for sexual problems due to anal incontinence but can be a part of the treatment. Strengths and Limitations: The study is a prospective study of sexual function. The limitations are that the questionnaires were not validated due to lack of such questionnaires at the time of the study and that the study population is quite small. Conclusion: Patients with a sphincter injury and fecal incontinence often have an impaired sexual function. Increased deferring time for stools after surgery increases the likelihood of improved sexual function.
文摘BACKGROUND High complex anal fistulas are epithelialized tunnels,with the main fistula piercing above the deep external sphincter and the internal opening approaching the dentate line.Conventional surgical procedures for high complex anal fistulas remove most of the external sphincter and damage the anorectal ring.Postoperative loss of anal function can cause physical and mental damage.Transanal opening of the intersphincteric space(TROPIS)is an effective procedure that completely preserves the external anal sphincter.However,its clinical application is limited by challenges in the localization of the internal opening of a fistula and the high risk of complications.On the basis of our clinical experience,we modified the TROPIS procedure for the treatment of treating high complex anal fistulas.CASE SUMMARY A patient with a high complex anal fistula located above the anorectal ring underwent modified TROPIS,which involved sepsis drainage and identification of the internal opening in the intersphincteric space.The patient with the high complex anal fistula recovered well postoperatively,without any postoperative complications or anal dysfunction.Anal function returned to normal after 17 months of follow-up.CONCLUSION The modified TROPIS procedure is the most minimally invasive surgery for anal fistulas that minimally impairs anal function.It allows the complete removal of infected anal glands and reduces the risk of postoperative complications.Modified TROPIS via the intersphincteric approach is an alternative sphincter-preserving treatment for high complex anal fistulas.
文摘目的探究三间隙引流术对高位肛周脓肿病人肛门功能、创面愈合及血清激活素A(ACTA)水平的影响。方法纳入西北大学第一医院2020年10月至2022年10月收治的48例高位肛周脓肿病人,依照治疗方案分为研究组和对照组,各24例。对照组病人行传统切开引流术,研究组行三间隙引流术。比较两组病人创面愈合时间、住院时间、术后视觉模拟评分法(VAS)评分及术后肛门功能;比较两组病人手术前后血清炎症因子、疼痛因子及ACTA水平变化。结果研究组术后创口愈合时间[(18.25±2.36)d比(22.25±3.12)d]、住院时间均较对照组缩短(均P<0.05);研究组术后7 d VAS评分低于对照组(P<0.05)。协方差主体间效应检验显示,研究组病人血清5-羟色胺(5-HT)、去甲肾上腺素(NE)水平较对照组降低(均P<0.05);术后7 d研究组Wexner量表评分[(7.07±0.97)分比(9.47±1.49)分]低于对照组(P<0.05)。术后7 d研究组血清白细胞介素(IL)-1β、C反应蛋白(CRP)、IL-6、肿瘤坏死因子α(TNF-α)、ACTA[(8.07±1.07)μg/L比(13.08±1.07)μg/L]水平较对照组降低(均P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论三间隙引流术创面小,可有效缓解病人疼痛,减轻炎症反应,降低ACTA水平及相关并发症发生率,保留肛门功能,改善病人术后生活质量。
基金Supported by Scientific Research Fund of China-Japan Friendship Hospital,No.2019-1-QN-53.
文摘BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function.
