The Value Of Prophylactic Ileal Fistula In Low Anterior Resection Of Laparoscopic Rectal Cancer

ObjectAnastomotic leakage is a serious complication of low anterior resection of rectal cancer, and mortality in patients with anastomotic leakage increased significantly. The Purpose of this paper to explore preventive terminal ileum stoma after low anterior resection of rectal Cancer by laparoscopy application.MethodRetrospective analysis of June 2011-January 2015 admitted 217cases of radical resection of rectal cancer patients of Gastrointestinal surgery of Second affiliated hospital of Kunming Medical University, meet the sample for this study of 100 patients with low rectal cancer, through the medical record patient medical records, major consultingprojects include gender、age、height、weight、age、underlying disease、 albumin、hemoglobin、personal history distance between tumor and the dentate linetumor type、postoperative anastomotic leakage、intestinal obstruction infection、 intestine ventilation and postoperative length of stay, and so on.Comparative study on 100 patients into preventive terminal ileum stoma(group A),40 cases of terminal ileum and not on preventive terminal ileum stoma(Group B) in 60 cases, comparison of postoperative anastomotic leakage,bowel obstruction,infection, intestinal ventilation and hospitalization, analyze the data using spss17.0 software.Result1、Displayed from the analysis of related factors of postoperative anastomotic fistula in patients with occur with tumor distance from the dentate line, tumor stage, diabetes, hypertension, smoking history, hypoalbuminemia and hyperlipidemia, the difference of them was statistically significant (P<0.05), however the gender, body mass index and pathologic types、coronary heart disease、chronic obstructive pulmonary disease and a long-term alcohol consumption, the difference of them was no statistically significant (P>0.05)2、100 cases of anastomotic leakage after total rectal patients in 11 cases of which 1 in group A, group B in 10 cases,there was a significant difference between the two groups(P<0.05).Incision Infection rates, which 2 in group A and 7 in group B, Incidence of ileus intestinal obstruction, which 1 in group A and 5 in group B, postoperative complication rate was 10% in the group A and 38.3% in the group B, Difference in incidence of postoperative complications in the two groups was statistically significant(P<0.05). Gut ventilation was 1.4±0.5 days in the group A and 3.2±0.6 days in the group B, Postoperative hospital stay was 7.3±0.9 days in the group A and 12.7±1.8 days in the group B± gut Ventilation and postoperative hospitalization time the two groups was statistically significant difference in statistics(P<0.05).conclusionIn high risk factors with cancer from the dentate line<3cm, advanced age,diabetes mellitus,hypertension,anemia, hypoalbuminemia as well as long-term smoking history low anterior resection of rectal cancer patients underwent laparoscopic colorectal cancer preventive terminal ileum stoma at the end select line when can effectively reduce the incidence of postoperative anastomotic fistula incidence and complications associated with anastomotic leakage.