Study On Application Of The Cuff Rectum Drainage Tube In Total Mesorectal Excision For Low Rectal Adenocarcinoma

Objective: To investigate therapeutic effect of cuff rectum drainage tube in preventing total mesorectal excision( TME) postoperative complications and promoting the recovery of the patients.Methods: The clinical data were obtained prospectively from 84 patients undergoing TME for flow rectal adenocarcinoma at our department during March 2014 and December 2015.They were carrying out anus-retained operation without preventive colostomy. Patients were divided into 2 groups according to the material of the anorectal drainage tube placed in the colonic cavity. Group I was transanal rectal cuff placement of drainage tube(Patent No.ZL 201320384337.8)(n=48) and group II was transanal placement of commonly used clinical common anus(n=36). A retrospective study was made for anastomotic fistula incidence?the time of anal exsufflation?postoperative first ambulation time? intestinal function recovery time ? tube complication incidence ?postoperative hospital stay and medical expenses between two groups.Results: Both postoperative first ambulation and anal exsufflation time were shorter in the cuff rectum drainage tube group[2.35±0.53) d and(3.35±0.53)d]than the clinical general anal tube group[(2.89±0.58)d and(3.89±0.40)d](P<0.05).Meanwhile, the cuff rectum drainage tube group had significance decreased postoperative hospital stay and medical expenses than that in the clinical general anal tube group[(10.46±1.74)VS(11.42±1.18)d], [5.21±0.42)VS(5.48±0.59) ten thousand yuan)](all P<0.05). Significant different occurrence of complications exist in anastomotic fistula, constipation defecating unfinished feeling drainage tube complication between the cuff rectum drainage tube group and the clinical general anal tube group[anastomotic fistula: 2.1%(1/48)VS16.7%(6/36)],constipation[8.3%(4/48)VS27.8%(10/36)], defecating unfinished feeling[ 12.5%(6/48)VS 30.6%(11/36)],drainage tube complication[4.17%(2/48)VS 22.2%(8/36))].Conclusion The cuff rectum drainage tube may reduce anastomotic fistula incidence in TME, decrease postoperative hospital stay and medical expenses, enable faster recovery and the patients 'toleration is good.