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Application of Transanal Tube Drainage in Low Rectal Cancer Resection

Author: XuHongXun
Tutor: LiuFang
School: Dalian Medical University
Course: Oncology
Keywords: Colorectal cancer low anterior resection Anal canal drainage
CLC: R735.37
Type: Master's thesis
Year: 2013
Downloads: 15
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Abstract


Objective:This study was to explore the anal canal drainage in low rectal cancer after anteriorresection in patients with gastrointestinal and anal function recovery and control ofpostoperative complications related to function.Method:Prospective analysis from January2011to December2012tumor hospital ofLiaoning province during the implementation of low rectal cancer resection in patientswith clinical data,The inclusion criteria were:preoperative line fibercolonoscopy;confirmed by pathology of rectal gland carcinoma,confirmed by fibercolonoscopy and anal diagnosis preoperatively edge of tumor from anal edge distanceless than or equal to10cm;preoperative life expectancy>6months; preoperative KPSscore80points or more;pre-operation without intestinal obstruction,tumor rupturebleeding;and so on, pre-operation without basic diseases such as anemia、hypoproteinemia、diabetes、and cardiovascular and cerebrovascular diseases,operationare performed by the same surgery group, it is according to the successfulimplementation of the radical resection before low TME principles during operation,allsuccessful follow-up3months after surgery,the anastomotic are located in theperitoneal reflected.We will low rectal cancer patients after grasp the sign method wererandomly divided into two groups.Which placed tubing drainage of anal canal number of cases, a total of134cases,without tubing drainage group the number of cases, a totalof176cases.We observed in patients with postoperative anal discharge liquid time forthe first time、evacuation time for the first time、the first time defecation time、incidenceof patients with postoperative abdominal distention,The incidence of postoperativepatients with anastomotic fistula and postoperative follow-up of patients with analfunction in patients with feeling even if is not clear.Then carries on the statisticalanalysis.Result:(1)There are134routine canal drainage in5case postoperatively in patients withanastomotic fistula in the treatment group,The incidence of anastomotic fistula was3.73%. There are176cases in the treatment group underwent canal drainage in17casepostoperatively in patients with anastomotic fistula, anastomotic incidence was9.65%.The patients out of the hospital after conservative treatment.There are176casesin the Control group without tubing drainage in17case postoperatively in patients withanastomotic fistula.The incidence of anastomosis was9.65%.8cases with conservativetreatment after3days, appeared signs of peritonitis,patients received transversecolostomy double chamber,after3months to be back.The rest of the9cases were out ofthe hospital after conservative treatment.The incidence of anastomotic fistula treatmentgroup is lower than the control group,statistical differences between them two.(2)Treatment group134of anal canal drainage in patients with postoperativedischarge liquid time; for the first time For the first time the exhaust time; First timedefecate tubing placed are earlier than the control group,176cases of patients, bothstatistical differences.(3)Treatment group134incidence of anal canal drainage in patients withpostoperative abdominal distention for31/134(23.13%), and the control group,176cases of tubing is not placed in patients with postoperative incidence of72/176(43.11%), the incidence of abdominal distension treatment group is lower than thecontrol group, both statistical differences.(4) In postoperative3months follow-up, the treatment group134of anal canaldrainage in patients with postoperative anal function (net) is superior to control group,176patients with tubing not placed both statistical differences.(5) In postoperative3months follow-up, the treatment group134of anal canal drainage in patients with postoperative anal function (frequency) and the control group,176cases have no tubing placed in patients with no difference in statistics.Conclusion:Low rectal cancer after anterior resection of tubing placed drainage can effectivelyreduce the occurrence of postoperative anastomotic fistula, promote the recovery ofpatients with postoperative anal function, promote the recovery of gastrointestinalfunction in patients with, make patients early exhaust and defecate, shortening time ofparenteral nutrition and beneficial to patients with postoperative recovery.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Rectal cancer
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