Impact Of The Tension Of Distal Bowel Combing Stapled Anastomosis In Rectal Cancer On Completeness Of Doughnuts

Objective: To study the influence of the tension of distal bowel on integrity ofdounghnuts and the happening rates of anastomotic leakage after total mesorectalexcision combing stapling techniques in middle and low rectal cancer,in order to reduceanastomotic leackage incidence and prevention of intestinal fistula with reference.Methods: From July2010to August2011,164paients who underwent anteriorresection with TME combing stapler anastomoses in Colonrectal Surgery Department inLiaoning Cancer Hospital were recruited and nonrandomly divided into tension relaxinggroup (61cases)and the traditional group(103cases).The longitudinal diameter of distaland proximal resection margin in the mucosal and seromuscular layer and postoperativeleakage rates were respectively compared between the two group.Results: There were no statistical differences in gender, age, height, weight,preoperative hemoglobin, distance of tumor from anal verge, postoperative TNMstaging between two group.The longitudinal diameter of proximal margin in the mucosal and seromuscularlayer by tension relaxing group was similar to control group(P>0.05).There arestatistical difference in the mucosal and seromuscular layer of the distal margin betweentwo group(p<0.05). The incidence of anastomotic leakage in tense relaxing group andtraditional group were1.64%(1/61) and10.68%(10/103) respectively(p<0.05）.No significance intergroup difference was foud in regard to intergrity of proximalmargin in the mucosal and seromuscular layer in rectal anastomosis(P>0.05).Thelongitudinal diameter of distal margin had statistical differences in anastomotic leakageoccurrence(p<0.05).Conclusion: Paying attention the tension of distal bowel combing stapled anastomosis could improve the integrity of the distal resection margine and decrease theanastomotic leakage occurrence when the patient was underwent anterior resection withTME combing stapler anastomoses.The mucosal and seromuscular layer of the distal resection margin are related tothe development of anastomotic leakage.