A Study Of Anastomosis Skill For Sphincter-reserving Operation In Rectal Carcinoma:use The Double Stapler Technique

Objective:To study the relationship between anostomotic leakage rate after sphincter-reserving operation and rectum tumor location, and explore anastomosis skill in colorectal anastomosis, special low colorectal anastomosis for prevention postoperative anostomotic leakage in rectal carcinoma use the double stapler technique.Methods:Between January 2006 and December 2010, 218 patients with rectal advanced cancer accepted total mesorectal excision and double stapler technique. According to the distance between tumor lower margin and anus, the patients divided into three groups: 38 patients in ultra-low group with the distance≤5cm; 65 patients in low group with the distance>5cm and≤7cm; 115 patients in middle-high group with the distance >7cm.Separate statistics the rate of anostomotic leakage in three groups. Given the small sample size, we combined ultra low group and low for a group further comparison with the middle-high group, to study the the relationship between anastomotic leakage and tumor location. Explore anastomosis skill in colorectal anastomosis use the double stapler technique with surgical experience and access to relevant literature.Result:12 patients developed postoperative anostomotic leakage in all patients,The rate was 5.5%(12/218). The rate of anostomotic leakage in ultra-low group was 10.5%(4/38), 7.7%(5/65)in low group, and 2.6%(3/115)in middle-high group. Moreover,short distance group with≤7cm group had 103 patient,whereas long distance group had 115 patients.Short distance group showed a significant increase in anostomotic leakage than long distance group, ( 9/103 ( 8.7% ) versus 3/115(2.6%),P<0.05).Conclusion:The distance between tumor lower margin and anus in rectal carcinoma was a critical factor in anastomosis healing,the closer to the anus,the higher leakage rate.Master of the anastomosis skill with double stapler technique can reduce the leakage rate.