Comparing The Occurrence Of Anastomotic Bleeding In Rectal Carcinoma Resection Between Laparoscopic And Open Radical Approaches, And Ways To Prevent And Manage It.

Objective To observe the occurrence of anastomotic bleeding between different approaches adopted i.e. laparoscopic and open radical resection for rectal carcinoma, and explore its influencing factors and ways to prevent and manage it. Methods There were 263 cases of rectal carcinoma enrolled and accepted radical resection in the study from Sept. 2000 to Jul. 2005. They were divided into 2 groups, laparoscopic surgery group (LS group, n=86) and open surgery group (OS group, n=177). According to the distribution of anterior resection (AR) and low/ultra-low anterior resection (LAR/UAR) with or without preventive colostomy, LS group and OS group could be further divided into several sub-groups, i.e. AR sub-group, LAR/UAR sub-group, colostomy sub-group and non-colostomy sub-group. After analyzing their incidence of anastomotic bleeding in each sub-group, a logistic regression model was established to determine the relationship between anastomotic bleeding and the three influencing factors including surgical method (LS or OS), location of stoma (AR or LAR/UAR) and preventive colostomy. Results The incidence of anastomotic bleeding in LS group and OS group were 9.30%(8/86) and 4.52%(8/177) respectively (P>0.05). In colostomy sub-group and non-colostomy sub-group, the incidence were 8.06%(5/62) and 5.47%(11/201) respectively (P>0.05). And in AR sub-group and LAR/UAR sub-group ,the incidence were 3.33%(6/180) and 12.05%(10/83) respectively (P>0.05). In comparing the influencing factor between the two different surgical methods, laparoscopic vs open radical, the coefficient of regression, odd ratio and standard coefficient of regression for laparoscopic surgery group were 1.319, 3.741 and 0.342 respectively. In comparison of locations of stoma (AR vs LAR/UAR), coefficient of regression, odd...