Risk Factors Of Anastomotic Leakage After Anus Preservation For Low And Mid Rectal Cancer

Objectives: To explore the risk factors of anastomotic leakage after anus preservation for low and mid rectal cancer.Methods: We conducted a retrospective case study to analyze the clinical data of 527 patients with middle and low rectal cancer treated by trans-abdominal anterior resection.The data comes from the First Affiliated Hospital of Nanchang University from January 2016 to December 2020.And Spss22.0 software was applicated for univariate logistic regression analysis of the relationship between anastomotic leakage and clinical factors,and univariate analysis(P<0.05)factors were included in multivariate logistic regression analysis to explore the risk factors of anastomotic leakage after rectal cancer surgery.Results: All 527 operations were performed successfully without conversion to laparotomy or intraoperative death.A total of 36 patients were diagnosis with postoperative anastomotic leakage were successfully discharged from hospital through symptomatic treatment or salvage stoma.Univariate logistic regression analysis showed that male,BMI ≥ 25 kg / m2,history of neoadjuvant therapy,tumor distance from anal margin(≤ 5cm),tumor invasion depth were related factors of anastomotic leakage after operation of middle and low rectal cancer(P < 0.05).Multivariate analysis showed that male,BMI ≥ 25 kg / m2,history of neoadjuvant therapy and tumor distance from anal margin were independent risk factors for anastomotic leakage after sphincter preserving surgery for middle and low rectal cancer,but tumor invasion depth was not.There was no significant correlation between anastomotic leakage and age,nutritional status,robotic or laparoscopic surgery,whether it was nose surgery or not,and whether it was preventive stoma.Conclusion: Male,obesity,close distance between tumor and anal margin and history of neoadjuvant therapy are independent risk factors of anastomotic leakage in patients with middle and low rectal cancer after sphincter preserving surgery.Those patients should pay more attention.