Familial Adenomatous Polyposis Comparative The Efficacy Analysis Of Two Surgeries

[Objective] To analyze recent and long-term statistical differences of complications and efficacy about the familial adenomatous polyposis have been accepted IPAA or IRA[Methods] Diagnosis and treatment of 6 patients with familial adenomatous polyposis admmitted from February of 2007 to April of 2010 were retrospectively reviewed。Meanwhile, we searched literature documents of other 67 patients from April of 2004 to May of 2010 in china,and then the clinical information of the familial adenomatous polyposis who have been operated IPAA and IRA has been anlyzed.Its recent and long-term complications and efficacy will classify through the following categories. Recent curative effect and complications included the timing of the operation, the length of hospitalization time, blood loss, postoperative exhaust or feeding time, infection of incision, bleeding, small bowel obstruction, pelvic infection, anastomotic leakage, etc. The long-term efficacy and complications included anastomotic stenosis, sexual dysfunction, night dung leak, etc. The above indexes medical records by quantitative data arrangement mean (x±s). T inspection is used in Intraclass analysis, Qualitative material show in The four-layer table.Counting material use chi-square test.[Results] There are 42 cases accepted IPAA in 73 cases,and 31 cases take IRA operation. Quantitative material sach as operation time, blood loss, Hospitalization days, Postoperative exhaust defecate etc, use spssl7.0 t-test, found in above index of IPAA art and IRA art have statistically significant differences (p=0.000). Incision infection rate do chi-square test, Continuous correction chi-square value is 0.000,p value is 1.000, so wo can think surgical incision infection rate of the two no statistically significant differences. Early night dung leak rate do chi-square test, Continuous correction chi-square value is 17.227,p value is 0.000,(p< 0.05), the difference was statistically different. Incidence of postoperative bleeding do chi-square test, Continuous correction chi-square value is 0.18,p value is 0.671, difference was statistically significant. Small bowel obstruction incidence do chi-square test,, Continuous correction chi-square value is 0.264, p value is 0.607, the incidence of small bowel obstruction don't have significant difference, do chi-square test, Continuous correction chi-square value is 0.000,p value is1.000, Pelvic infection rate don't have significant difference. Anastomotic leakage rate do chi-square test, Continuous correction chi-square value is 0.109, p value is 0.741, anastomotic leakage rate don't have significant difference. Anastomotic stricture rate do chi-square test, Continuous correction chi-square value is 1.387,p value is 0.239, difference was statistically significant. Sexual dysfunction incidence do chi-square test, Continuous correction chi-square value is 1.402, p value is 0.236, the incidence of sexual dysfunction is similar between two operation.[Conclusion] Familial adenomatous polyposis is a dominant inherited diseases, its major clinical manifestations include blood stool, abdominal pain, diarrhea. Surgical treatment of familial adenomatous polyposis, IPAA's surgical wounds and technical difficulties is more than IRA. The incidence of complications sach as Incision infection, bleeding, small bowel obstruction, pelvic infection, anastomotic leakage, anastomotic stricture, sexual dysfunction don't have statistically significant differences. In the early night dung leakage rate,there is Significant statistically differences. Due to the resection of rectum mucous membrane thoroughly, the feeling of rectum demonstrate function abate, affect contractive function of Rectum canal ring, lead to the incidence of early night dung leakage increased. Daily defecate number significantly higher than normal levels. Some patients have occasional night dung leak but not affect daily life. The anus feel function is good, can clearly distinguish gas and liquid. The anus resting pressure can reach 40 mmHg. Over the quality of life Defecating function, two groups were similar. because Completely removed the colorectal mucosa, he incidence of postoperative adenomatous polyp is very low. Patients have different degrees of polyps relapse, atypical hyperplasia and cancer. In the treatment FAP, IPAA is the ideal cases.