Analysis Of Related Factors Of Colorectal Anastomotic Leakage In Colorectal Surgery

Background Colorectal anastomotic leakage in colorectal surgery is the most serious complications. With more and more specialized colorectal surgeon, post-operative colorectal complications is diminishing, but the occurrence of anastomotic leakage rate has no downward trend. It is still a long-term mission to the surgeons to assess the relevant factors leading to colorectal anastomotic leakage, because there are still controversial about risk factors of occurrence of anastomotic leakage in colorectal surgery over a long period of time following varying hospital reportsObjective To study the impact of the different colorectal anastomotic plane on the occurrence of anastomotic leakage, and the impact of preventive transverse colostomy and gender on the occurrence of anastomotic leakage of the middle and lower rectal anastomotic plane.Methods Retrospectively analysis with 478 cases of colorectal surgery patients of Department of General Surgery, the Second Affiliated Hospital of Shanxi Medical University from June 1998 to June 2008, according to the different colorectal anastomotic plane in operation the patients are divided into three groups , It is respectively transverse colon plane and sigmoid colon or upper rectum plane and middle and lower rectum plane, using Chi-Square Tests to study the impact of the different colorectal anastomotic plane on the occurrence of anastomotic leakage, and the impact of preventive transverse colostomy and gender on the occurrence of anastomotic leakage of the middle and lower rectal anastomotic plane.Results The occurrence of anastomotic leakage rate of transverse colon anastomotic plane and sigmoid colon or upper rectum anastomotic plane and middle and lower rectum anastomotic plane conducted without preventive transverse colostomy is 0% and 2.7% and 8.4% respectively, having statistical differences (P<0.05), There is statistical difference(P <0.0167) between transverse colon anastomotic plane with middle and lower rectum anastomotic plane conducted without preventive transverse colostomy, There is no statistical difference(P> 0.0167)between transverse colon anastomotic plane with sigmoid colon or upper rectum anastomotic plane and sigmoid colon or upper rectum anastomotic plane with middle and lower rectum anastomotic plane conducted without preventive transverse colostomy; There is no statistical difference (P>0.05)between the occurrence of anastomotic leakage rate of middle and lower rectum anastomotic plane having not preventive transverse colostomy with that having preventive transverse colostomy which is 3.2%, There is also no statistical difference(P>0.05)between female(4.5%) and male patients(11.4%)about the occurrence of anastomotic leakage rate of middle and lower rectum anastomotic plane without preventive transverse colostomy conducted.Conclusion The incidence of colorectal anastomotic leakage has closely related with the anastomosis plane. The lower plane of anastomosis, the higher incidence of anastomotic leakage; middle and lower rectum anastomotic plane with preventive transverse colostomy can not effectively reduce the occurrence of anastomotic leakage rate; Gender is not the decisive factor to the occurrence of anastomotic leakage rate of middle and lower rectum anastomotic plane.