Tube bundle type coloanal anastomosis for rectal cancer 28 cases _1091

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Tube bundle type coloanal anastomosis for rectal cancer 28 cases
 
 
Anal anastomosis tubes made of Results. The tube pre soaked with 75 ethanol 1h spare. 1.3 surgical procedures (1) abdominal group: In accordance with the principles of TME, the full free sigmoid colon and descending colon. In the mesenteric vascular ligation cut, cut 3 / 4, Department of Film and tumor proximal sigmoid colon 15cm, down to the levator ani muscle of free rectum. Keep the colon marginal artery arch, under the free use of right-angle clamp to cut off the tumor, remote from the tumor 2 ~ 3cm, reserved 1 ~ 2cm above the dentate line the rectum; proximal resection of the colon 10 ~ 15cm away from the tumor, whether the observed upper and lower cutting edge tumor invasion. Proximal colon anastomosis after routine disinfection control human colon, respectively, with 7 silk thread tied at two ends of the colon anastomosis tube, after removal of the rectum out. (2) perineal group: After routine disinfection anal expansion, up to 4 refers to the date. Fully exposed to 1cm above the dentate line, with 1 full-thickness circular catgut suture purse, will the colon through the anal canal anastomosis tubes out. Consistent with the first one ligature tube falls dentate line, the first two ligatures just landed on the purse suture ligation. Point No. 4 silk suture anastomosis in the 3,6,9,12 tube in the anus, to prevent extrusion and retraction. Both groups were placed in the presacral drainage tube suction lumen, abdominal pelvic into the abdominal group FU 1g flushing, tight pelvic peritoneal suture, and finally followed by the abdomen was closed. 1.4 Results There was no death in this group of patients, cutting edge shows no residual tumor by pathology, anastomotic leakage did not occur; a mild anastomotic stenosis in 3 cases,You are not allowed to view links. Register or Login, the enlarged anal cure. 1 year after defecation in accordance with the literature [Comprehensive Evaluation Method: excellent in 14 cases; good in 12 cases; fair in 2. Excellent rate of 92.9. 2 discussions Pompiliu such reports TME rectal root 611 * local recurrence rate rule 1.9 ~ 5.0; Heald and so on. . Radical surgery with TME, local recurrence rate of 4.0; Yu Baoming other _4] reported local recurrence rate was 6.7. Doxin is the first choice for low rectal cancer surgery, double stapling technique is one of the ideal, but obesity, pelvic too narrow, too short stump patients, difficult anastomosis. Tube bundle type coloanal anastomosis without pelvic width,You are not allowed to view links. Register or Login, obesity, muscle strength, the length of rectal stump can be smoothly matched expansion, bleeding, drainage, avoiding preventive colostomy, and the incidence of anastomotic leakage low. This group of cases of anal function after good rate was 92.9,You are not allowed to view links. Register or Login, 7.1 rate of local recurrence, suggesting that the surgical safety and reliability. The surgical advantages: (1) no suture pelvic difficult to avoid the agreement by the anus out of hand the complexity and risk. (2) to avoid a Bacon or a lack of surgical Parks without shunt colostomy. (3) not left screw suture and stapled, with few complications. (4) is simple,You are not allowed to view links. Register or Login, can be undertaken at all levels of the hospital. In addition, the completion of the surgical procedures should note the following: (1) a comprehensive examination before surgery, to correct anemia, hypoproteinemia, hyperglycemia, cardiac insufficiency, and water and electrolyte disturbance. Completely improve bowel preparation. (2) pay attention to check the submucosa, serosa edge of the aortic arch blood supply. (3) undue tension out of the proximal colon, more than 10cm and under the pubic symphysis to guard against distortion of rotation. (4) distal rectal pouch suture should be even close, not leak needle, ligated solid and reliable. (5) presacral drainage tube placement, adequate drainage. (6),You are not allowed to view links. Register or Login, consistent with management to strengthen the management of patients, to prevent the ride into the anus.