Analysed The Curative Impact Of Transanal Drainage Tube To Colorectal Cancer With Obstruction

Objective:To explore the impact of transanal drainage tube to colorectal cancer with acute obstruction convert the emergency operation into the elective operation.Methods:Choosing 117 patients diagnosed colorectal cancer with acute obstruction treated in gastrointestinal surgery of hospital during 1 May 2011 to 30 May 2015. Collected the basic data for all the enrolled patients.According to whether to apply the transanal drainage tube convert emergency surgery into elective surgery to divide the patients into emergency surgery group or elective surgery group.Measured preoperative and postoperative blood biochemical indexes of two groups of patients,statistics of two groups of patients with surgical styles, postoperative complications and postoperative pathological results and follow up survival time.Measurement data were presented as mean ± standard deviation(`x± SD),normal data using two-sample t test to compare between-group differences, enumeration data using ?2 test to compare between-group differences, using the Kaplan-Meier survival curve drawing method, the survival rate comparison and prognostic factors univariate analysis was performed using Log-rank test, multivariate analysis using Cox proportional hazards regression model.Results:1.Preoperative ASA score in emergency surgery group is higher than elective surgery group and preoperative serum albumin level is lower than it(P<0.05).Tumor one stage resection and anastomosis and the application of laparoscopic surgery is significantly inferior to elective surgery group(P<0.01).2.Emergency surgery patients in postoperative fever, bacteremia, intraabdominal infection, leg edema, hyponatremia, hypokalemia, hypoalbuminemia,asastomotic fistula, in-hospitalization death is higher than elective surgery group(P<0.05).And pulmonary infection,nausea,vomiting,postoperative ileus,surgical wound infection was no significant difference with two groups(P>0.05).3.The elective surgery group on the number of lymph node dissection(14.8±5.7)is significantly higher than emergency surgery group(10.6±8.8)(P<0.01).4.Univariate analysis showed: preoperative CEA and CA19-9 increased,ASA score ?3 points,TNM stage ?III stage,histological type poorly differentiated adenocarcinoma, mucinous adenocarcinoma, tumor size ?5cm,the number of lymph node dissection <13, peripheral nerve tumor invasion positive, emergency surgery as affecting patient survival and disease-free survival risk factors(P <0.05). Multivariate analysis showed: number of lymph node dissection <13, perineural tumor invasion-positive were the independent risk factors for the survival prognosis and disease-free survival prognosis(P<0.05). Tumor size ?5cm, emergency surgery was the independent risk factors for the disease-free survival prognostic(P <0.05).Conclusions:Application of the transanal drainage tube can effectively convert the emergency surgery into the elective surgery in colorectal cancer patients with acute obstruction,So as to obtain good preoperative preparation,to reduce the incidence of postoperative complicaitons in patients and to have survival benefit.It can be an effectively measure for the treatment of colorectal cancer with acute obstrucion.