Clinical Efficacy Analysis Of Endoscopic Intestinal Stent Placement In Patients With Postoperative Anastomotic Leak After Colorectal Cancer Surgery

Objective: To observe the efficacy of endoscopic intestinal stent placement for anastomotic leak after colorectal cancer surgery,in order to provide reference for clinical diagnosis and treatment.Methods: Retrospectively collected 21 patients with colorectal postoperative anast omotic leak after colorectal cancer surgery treated by Fujian Medical University Union Hospital from June 2014 to August 2020 were underwent SEMS placeme nt for the treatment of anastomotic fistula.The clinical data of 21 patients were retrospectively analyzed.To observe and analyze the site of clinical data(Gender,age,preoperative nutritional status,preoperative radiotherapy and chemotherapy,surgical method,surgical site,tumor stage,etc.),technical success rate,clinical success rate,complication ates,endoscopic treatment effect,complication rates(m-igration,perforation,anorectal rectal pain,diarrhea).Results: Of the 21 patients,21 were successfully placed with a stent,and the technical success rate was 100%(21/21).After clinical symptoms,signs,and re-examination imaging findings,15 cases of anastomotic leak were relieved,and the clinical success rate was 71.4%(15/21).During postoperative follow-up,four of the 21 patients(19.0%)with successful stent placement had major complications,mainly stent displacement,and six had secondary complications,of which 19%(4/21)had perianal pain and 9%(2/21)had diarrhea.There were no cases of stent placement failure in the 21 patients with stent implantation,anastomotic fistula did not heal after stent implantation in 6 cases,and intestinal stent implantation was performed again in 1 of the 6 cases without healing.Follow-up confirmed fistula healing.5 of the 6 unhealed patients underwent surgical treatment,i.e.ileum or colostomy,and received postoperative parenteral nutrition support,anti-infection,adequate drainage and other treatments.Finally,the fistula healing was confirmed by fistula angiography.Comparing the different sites of anastomotic fistula,that is,the different locations of intestinal capsular stent placement,13 cases were placed in the rectum,2 cases in the left colon,and 6 cases in the right colon.Non-healing of anastomotic fistula occurred in 5 cases when the intestinal capsule stent was placed into the rectum.Clinical efficacy can be divided into healing and non-healing in the two groups,contrast between the two groups of clinical and endoscopic data commonly,found the stoma size,found time to anastomotic fistula after operation,postoperative support time to place the intestinal capsule treatment effect is no statistical difference,and anastomotic is apart from the position of the anus and whether preoperative prophylactic ileum colostomy was statistically difference,is the important factors that affect the fistula healing(P < 0.05).Conclusion: Endoscopic intestinal stent placement of patients with anastomotic leak after colorectal cancer is safe and effective,which has certain feasibility and clinical value.Timely endoscopic intervention in the treatment of anastomotic fistula will benefit more patients,and avoid the physical and psychological pain and high medical consumption caused by the second operation.