Study On The Internal Correlation Of The Intestinal Function After Stapling Anastomosis In Patients With Rectal Caneer

ObjectiveThrough observing anastomosis location, range of rigid wall, condition ofanastomotic inflammatory and edema and following up, we investigated the effect of thethree aspects on the intestinal function and segmental aperistalsis syndrome, and wish thework can provide new ideas for the development of seamless stapler.Methods100patients who received colorectal anastomosis with stapling technique weredivided into3groups according to the distance between anastomosis and dentateline (A:0-2cm, B:2cm~4cm; C:>4cm), patients also were divided into3groupsaccording to the range of rigid wall(I: no rigid wall, II:0cm~1cm; III:>1cm),and patients also were divided into2groups according to the condition of anasto-motic inflammatory and edema. All the patients’ intestinal function was evaluatedwith Zhong-Fa Xu’s evaluation criteria and was divided into3groups too(Good:score0-4.premium: score5-8poor: score9-10). Ordinal multinomial logistic regr-ession was used were used for analysis of the effect of the three aspects on theintestinal function. P<0.05indicates significant difference. Multivariate logistic reg-ression analysis were used for analysis of effect of the three aspectsl on inciden-ce of segmental aperistalsis syndrome. Results1. Effect of anastomosis location on the intestinal function There are27patients ingroup A,39patients in group B,34patients in group B. Chi square test of single factor（χ2=19.553, P=0.001）shows there was a significant correlation between anastomosis-location and intestinal function.Ordinal multinomial logistic regression shows the lowerof the position of anastomosis, the worse of the intestinal function after thesphincter-preserving surgery of low rectal cancer.2. Effect of range of rigid wall on the intestinal function. There are40patients ingroup I,35patients in group II,25patients in group III. Chi square test of single factor（χ2=13.259, P=0.01）shows there was a significant correlation between range of rigidwall and intestinal function. Ordinal multinomial logistic regression shows the longer ofrange of rigid wall, the worse of the intestinal function after the sphincter-preservingsurgery of low rectal cancer.3. Effect of condition of anastomotic inflammatory and edema on the intestinalfunction. There are71patients in group1,29patients in group2. Chi square test ofsingle factor （χ2=6.087, P=0.048）shows there was a significant correlation betweencondition of anastomotic inflammatory and edema and intestinal function. Ordinalmultinomial logistic regression shows patients with anastomotic inflammatory andedema has worse intestinal function.4. Effect of anastomosis location on segmental aperistalsis syndrome There are27patients in group A,39patients in group B,34patients in group B. Chi square test ofsingle factor （χ2=2.969, P=0.227）shows there was no correlation between anastomosislocation and segmental aperistalsis syndrome.5. Effect of range of rigid wall on the segmental aperistalsis syndrome. There are40patients in group I,35patients in group II,25patients in group III. Chi-square test of single factor （χ2=17.831, P=0.000）shows there was a significantcorrelation between range of rigid wall and segmental aperistalsis syndrome. Ordin-al multinomial logistic regression shows the longer of range of rigid wall, thehigher incidence of segmental aperistalsis syndrome. 6. Effect of condition of anastomotic inflammatory and edema on segmentalaperistalsis syndrome There are71patients in group1,29patients in group2.Chi-square test of single factor （χ2=8.883, P=0.003）shows there was a significan-t correlation between anastomotic inflammatory and edema and segmental aperista-lsis syndrome. Ordinal multinomial logistic regression shows the incidence ofsegmental aperistalsis syndrome in the patients with anastomotic inflammatory and edema is higher than that without anastomotic inflammatory and edema.Conclusion1. For the sphincter-preserving surgery of low rectal cancer, the lower of theposition of anastomosis, the worse of the intestinal function.But there was nocorrelation between the position of anastomosis and segmental aperistalsis syndrome.2. For the sphincter-preserving surgery of low rectal cancer, the longer of range of rigid wall, the worse of the intestinal function and the higher incidence ofsegmental aperistalsis syndrome.3. For the sphincter-preserving surgery of low rectal cancer,patients with anastomotic inflammatory and edema has worse intestinal function and higher incidence of segmental aperistalsis syndrome compared with patients without anastomotic inflammatory and edema.