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BACKGROUND AND PURPOSE: The incidence of colorectal cancer increased year by year, has leapt to 3-5. About 70% of the incidence of rectal cancer, and peritoneal fold below the level in low rectal cancer. With the biological behavior of rectal cancer, lymph node metastatic pattern of in-depth research and double stapling rectal the mesorectal resection of application, there are more and more low or even ultra-low rectal cancer underwent knot rectal anastomosis significantly improved the patient's quality of life. Anal sphincter preservation often appears after a certain amount of intestinal dysfunction, nail anastomosis due to foreign body left there are some disadvantages. Many clinicians since that surgery was very successful, and failed to pay attention to the pain of patients with intestinal dysfunction, or even ignored. Us through the application of the follow-up nail stapling sphincter preserving surgery of colorectal cancer patients, to explore changes in bowel function, and then analyze the nail anastomosis of bowel function, provide a theoretical basis for new nail stapler developed and ideas. Methods: from January 2007 to December 2009, General Surgery, the application of nail-stapling sphincter preserving surgery in Shandong Tumor Hospital 95 cases of colorectal cancer patients as the research object. Anastomosis from the dentate line distance is divided into three groups (ultralow: lt; the 2cm, low: 2cm ~ peritoneal reflexed Department, to high: peritoneum above). Functional follow-up of all patients after 6 months and 1 year were 67 cases and 30 cases underwent colonoscopy examination, the results are divided into three groups (A: anastomotic smooth, good bowel movements; B: consistent port limitations granuloma or uplift; C: anastomotic stenosis, circumferential stiffness, bowel loss of peristalsis). Press of Xu Zhong Act five very system evaluation criteria after January, March, June, 1 year on all patients with bowel function evaluation. Using one-way analysis of variance test the anastomotic plane of peristalsis recovery, one-way analysis of variance test of time and anastomotic plane bowel function, chi-square test analysis of patients with diarrhea and constipation occurs. P lt; 0.05 indicates that the difference was statistically significant. Results: 1. Bowel function evaluation: postoperative January, March, June, 1 year, the overall rating of excellent in a ratio of 2.1%, 23.2%, 32.6%, 54.7%; the total score Liang who share were 24.2%, 26.3%, 36.8%, 34.7%; overall score of the general proportion of 35.8%, 30.5%, 27.4%, 10.5%; overall rating of poor proportion of 37.9%, 20.0%, 3.2%, 0%; 2. peristalsis recovery: into the group of patients with postoperative bowel recovery time was 4.62 ± 1.11 days. Ultralow group 4.65 ± 1.03 days the low group 4.51 ± 1.08 days, the high level group to 4.74 ± 1.24 days. Recovery of bowel movement between the three groups no significant differences in the number of days (F = 0.383, P = 0.683). Bowel function influencing factors: the time factor ultralow group: the January vs.3 P = the 0.000,1 month vs.6 P the years of vs.1 = 0.000,1 month, P = 0.000,3 vs.6, monthly P = 0.002,3 ??May, vs.1 P the years of vs.1 = 0.000,6 months, P = 0.008; The lower bank: P value: 0.001,0.000,0.000,0.052,0.000,0.009; highs group P values ??were The as 0.055,0.000,0.000,0.009,0.000,0.020. In addition the the low group on March vs.6 and high group in January vs.3, there were significant differences. ② anastomotic the plane factor in January ultralow vs. Lows P = 0.007, low vs high P = 0.000, ultra-low vs. high P = 0.000; the three month P value: 0.036,0.000,0.000; June when P values ??were: 0.001,0.001,0.000; 1 when P values ??were: 0.015,0.000,0.000. The differences were statistically significant. Alternating diarrhea and constipation: the time factor ultralow group: January compared with March completely improved in January vs.6 P the years of vs.1 = 1.000,1 months, P = 0.009,3 months vs. June P = the 1.000,3 month vs.1 P the years of vs.1 = 0.009,6 months, P = 0.047; the lower bank: P value: 0.212,0.001,0.000,0.018,0.000,0.001; highs group P value were 0.167,0.147,0.011,1.000,0.238,0.492. ② anastomotic the plane factor in January ultralow vs. Lows P = 0.288, low vs high P = 0.000, ultra-low vs. high P = 0.000; the three month P value: 0.043,0.000,0.000; June when P values ??were: 0.001,0.001,0.000; 1 when P values ??were: 0.000,0.008,0.000. The remaining group differences were statistically significant except when ultra-low bit January with the low group. Colonoscopy results: 6 A group of 21 patients, 4 patients with diarrhea alternating with constipation, ultra-low and low patients each half; B group of 30 patients, 12 patients, all for low or ultralow by; C group of 16 patients, 15 patients, while one case of those in high office. A group of 16 patients 1 year ultralow patients with alternating diarrhea and constipation; B group of 14 patients, 6 patients are low or ultralow; C group (n = 8) were all present, are low or ultra-low bit persons. Conclusion 1. Knot rectum nail anastomosis on postoperative recovery of bowel movement had no significant effect; 2. Colorectal anastomosis nail patients there are different degrees of intestinal dysfunction, especially in June; With the passage of time bowel function gradually improved; higher anastomotic flat, better bowel function, lower anastomotic plane, the worse bowel function. Anastomosis affect colorectal nail-colon movement, its prominent clinical manifestations are diarrhea alternating with constipation. Higher anastomotic plane, the performance of the more obvious the lower plane of anastomotic more obvious manifestations, and improve the worse. Intestinal dysfunction affecting the quality of life of patients, anastomosis technique should be further improved.
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