关键词: 右半结肠癌, 术后腹泻, 端侧吻合, 侧侧吻合

Abstract: Objective To analyze the effects of end-to-side ileocolon and side-to-side ileocolon on diarrhea after radical resection of right colon cancer.Methods Total 90 right colon cancer subjects from Jingzhou First People's Hospital between June 2019 and June 2021 were recruited.According to different surgical anastomosis methods,patients were divided into group A(30 cases):ileocolonic anastomosis was performed by end-to-side anastomosis with A 25 mm circular stapler,and the colon stump was 5 cm;Group B(30 cases):ileocolonic anastomosis was performed end-to-side anastomosis with a 25 mm circular stapler,and the colon stump was 10 cm;Group C(30 cases):ileocolon anastomosis was performed side-to-side with a 75 mm linear cutter and closure device.Multivariate Logistic regression was used to analyze the risk factors of postoperative diarrhea and compare the effects of different surgical anastomosis methods. Results The results showed that 35 patients developed postoperative diarrhea, univariate analysis showed that age(P=0.033)，club ratio(P=0.015)，anastomosis(P=0.014)，recovery time(P=0.024)，postoperative antibiotic time(P=0.033) had statistical significance between diarrhea group and non-diarrhea group.Multivariate analysis showed that club ratio(P=0.012,OR=0.195) was an independent factor influencing the occurrence of diarrhea after right colon cancer.There were statistically significant differences between group A and group C(P<0.01,OR=0.181) and group B and group C(P=0.021,OR = 2.243).There was no statistical significance in group A compared with group B(P=0.661,OR=1.339).Therefore,the anastomosis method is also an independent factor influencing the occurrence of postoperative diarrhea in right colon cancer.There were statistical differences in the number of postoperative daily diarrhea(P=0.028),duration of postoperative diarrhea(P=0.045),intestinal sIgA(P=0.018) and blood D-lactic acid(P= 0.019) between the end-to-side anastomosis group and the side-to-side anastomosis group.
 Conclusion 1.Age,club ratio,anastomosis method,recovery time of liquid food and postoperative antibiotic time were correlated with the occurrence of diarrhea after right colon cancer radical resection.2.Club ratio and anastomosis were independent risk factors for diarrhea after radical resection of right colon cancer.3.The incidence and degree of postoperative diarrhea were both lower in the end-to-side anastomosis group than in the side-to-side anastomosis group,and the effects of simulated cecum 5 cm and simulated cecum 10 cm on postoperative diarrhea were similar.4.The changes of intestinal sIgA and blood D-lactic acid may be the mechanism of end-to-side anastomosis and side-to-side anastomosis affecting postoperative diarrhea.

Key words: right colon cancer, postoperative diarrhea, end-to-side anastomosis, side-to-side anastomosis