Application Of Indentation Anal Canal In Laparoscopic Anal Preservation For Middle And Low Rectal Cancer

Objective:To explore the preventive effect of transanal drainage tube on anastomotic leakage after laparoscopic middle and low anterior rectal resection,and whether it can accelerate the recovery of gastrointestinal function of patients,so as to guide the future clinical work.Methods:A retrospective analysis was performed on 234 patients who underwent laparoscopic anterior resection of low and middle rectal cancer in the General Surgery Center of the Second Hospital of Jilin University from May 2019 to June 2021.The experimental group and control group were divided according to whether or not there was a transanal tube.The incidence of anastomosis and the recovery rate of gastrointestinal function were compared between the experimental group and the control group.Results:There were no statistically significant differences between the experimental group and the control group in preoperative age,gender,underlying diseases,BMI,ASA score,tumor size,location and stage（p>0.05）.The overall incidence of postoperative anastomotic leakage was 5.13%（12/234）.The incidence of anastomotic leakage was2.7%（4/148）in the experimental group and 9.3%（8/86）in the control group,the difference was statistically significant（p=0.034）.The incidence of postoperative abdominal distension was 9.5%（14/148）in the anal catheter group and 25% in the control group,the difference being statistically significant（P =0.001）.The time of exsufflation was 68.55±10.196 minutes in the group with transanal tube and75.67±15.142 minutes in the control group,the difference was statistically significant（p=0.002）.Conclusions:Transanal tube can reduce the incidence of anastomotic leakage after laparoscopic middle and low anterior rectal resection and accelerate the recovery of postoperative gastrointestinal function and reduce the incidence of abdominal distention.The transanal tube is an independent protective factor for postoperative anastomotic leakage.The distance between tumor and anal margin ≤5cm and tumor diameter ≥4cm are independent risk factors for postoperative anastomotic leakage.