[Value of protective stoma in intersphincteric resection for ultra-low XXXX ].

@entity1 @entity834 @entity322 @entity5 @entity254 @entity260 @entity24338
OBJECTIVE: To investigate the value of protective stoma in intersphincteric resection (ISR) for ultra-low @entity5 . METHODS: Clinical data of 56 ultra-low @entity5 @entity1 without involvement of external anal sphincter treated during January 1999 to July 2009 with trans-anal ISR plus trans-abdominal total mesorectum excision and coloanal @entity254 were retrospectively analyzed. The @entity1 were divided into two groups based on whether they received protective ostomy: ostomy group (16 cases) and ostomy-free group (40 cases). The @entity260 as well as anal functional restoration were compared between the two groups. RESULTS: Sixteen cases (32.1%) of the 56 @entity1 received protective stoma. The complication rate of @entity254 and anus complication rate in the ostomy-free group were significantly higher than those in ostomy group [35.0% (14/40) and 40.0% (16/40) vs. 1/16 and 1/16; P < 0.05]. In the ostomy-free group, one @entity1 developed @entity834 dehiscence and @entity5 recurrence, the @entity1 was given permanent colostomy, and the other three @entity1 with lesions in the @entity254 and @entity24338 and secondary surgical treatment, with a reoperation rate of 10.0% (4/40). The anal function of @entity1 in the two groups were both decreased after the operation. The rate of @entity1 got Kirwan grade I anal sphincter function in the 3rd, 6th and 12th month after protective stoma operation was 11/16, 13/15 and 11/13 in the ostomy group, respectively; and those were 30.0%, 37.5% and 45.0% in the ostomy-free group, respectively. Anal function was significantly better in the ostomy group than that in the ostomy-free group during the same postoperative period (P < 0.05). CONCLUSION: Protective stoma can avoid @entity834 following ISR for ultra-low @entity5 , and alleviate the suffering of anal @entity322 in the early postoperative period, and is conducive to the restoration of anal function.
