| Objective：To discuss the value and significance of temporary ileostomy inpreventing anastomotic leakage following the low rectal cancer surgery.Methods:Retrospectively analyze172cases of patients who visitedChina-Japan Union Hospital of Jilin University in September2009-August2014dealed with low rectal cancer surgery in GastrointestinalSurgery and Colorectal Surgery.The patients whose tumer to the anal vergeis4-6cm and checked by colonscope had been chosen,except those withintestinal obstruction,liver metastasis, pulmanory metastasis and thoseunderwent neoadjuvant radiotherapy and chemotherapy before surgery.Thepathology test had confirmed to be rectal adenocarcinoma. Analyze therelationship of anastomotic leakage with the age,sex,operationmethod,tumer organizational type, tumor clinical TNM staging andpreventive measures (temporary ileostomy) of patients.Divide the172patients into two groups according to whether he adopted preventivemeasures,those were the experimental group(temporary ileostomy) and thecontrast group(without temporary ileostomy),there were55patients in theexperimental group,117patients in the contrast group.Analyze the reasonwhy temporary ileostomy can prevent anastomotic leakage after low rectalcancer surgery and illustrate the value and significance of temporaryileostomy via comparing data of postoperative anastomotic leakageincidence, reoperation rate, the time of eating and hospital stay length.Results:1、The comparison of the incidence of postoperative anastomoticleakage and reoperation rate between two groups:1case of55patientsdeveloped anastomotic leakage in the temporary ileostomy group,the incidence rate was1.8%.The number of the contrast group was14.5%with17cases in117patients.p=0.0397<0.05.The1case with leakage had slightsymptoms and restored to health with a short-term expectant treatment.5cases of patients in the contrast group resumed after expectant treatmentand12cases resumed with transverse colostomy. The reoperation rate ofthe experimental group was0%but the data of the contrast group was10.3%,p=0.048<0.05.Two groups of data had statistical significance.Thetemporary ileostomy significantly reduced incidence of anastomoticleakage and reoperation rate after the rectal cancer surgery,even if theleakage occured,the symptoms of patients with temporary ileostomy werelighter,resumed faster.2、The relationship of the age, sex, operation way,tumor clinical TNM stage, tumor organizational type of patients and theoccurrence of anastomotic leakage.Statistically analyzing the results ofabove factors between two groups,we drawed that p=0.1559>0.05、p=0.98>0.05、p=0.991>0.05、p=0.11>0.05、p=0.931>0.05.According to theresults we concluded that the occurrence of anastomotic leakage hasnothing to do with the above factors.3、The contrast of postoperative firsteating time and length of hospital stay of patients between two groups.Thepostoperative first eating time of the experimental group was in3.5±0.85days after surgery and the data of the contrast group was4.5±0.87days.t=-3.36，p=0.003<0.05，the length of stay in hospital of theexperimental group was16.2±3.5days and the data of the contrast groupwas24.5±6.5days.t=-3.64,p=0.002<0.05.The results concluded thattemporary ileostomy can make patients eat faster after surgery and shortenthe length of stay in hospital.Conclusions:1、There is no relationship between the anastomotic leakage after low rectal cancer surgery and the age, sex, operation method and organizationalcredit, tumor clinical TNM staging of patients.2、Temporary colostomy canobviously reduce the incidence of anastomotic leakage after low rectalcaner surgery and reoperation rate and even if the leakage occured，it canreduce the damage.3、Temporary ileostomy can make patients eat fasterafter surgery and shorten the length of stay in hospital，speed up therecovery time of patients.It’s a simple method of safely and effectivelypreventing anastomotic fistula after low rectal cancer surgery and worthy toadopt in clinical popularly. |
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