Risk Factors And The Management Of Anastomotic Leakage After Anterior Resection For Rectal Cancer

Objective:To investigate the risk factors and management of anastomotie leakage after radical resection for rectal cancer and preservation of anal sphincter.Methods:Clinical data of 318 cases in recent 5 years from 2005 to 2010 of rectal cancer patients after anus-preserving operation were retrospectively analyzed.Results:Of the 318 cases,14 cases developed anastomotic leakage, the occurrence rate was 4.4%.13 cases of anastomotic leakage were healed by conservative therapy, the other 1 patient was healed by secondary operation. This set of data shows that hypoproteinemia after the operation, diabetes, distance of tumor from anal verge less than 7cm, hand-stitched did not added after stapler anastomoses have significant correlation with anastomotic leakage, the x 2 test P value were 0.027,0.044,0.045,0.033. While the patients with diferent ages, sexes, tumor size, tumor pathology type, clinical stage, ways of bowel preparation, ways of anastomosis, tumor diameter mole than 4cm and bowel obstruction before operation had no relation in anastomotic leakage occurrence.Conclusions:Poor general condition, position of the tumor, diabetes, anastomoses techniques are related to the development of anastomotic leakage (P< 0.05).Ages, sexes, tumor size, tumor pathology type, clinical stage, ways of bowel preparation, ways of anastomosis, and bowel obstruction before operation had no relation in anastomotic leakage occurrence. Early and active conservative approach should be considered as the main and effective treatment of anastomotic leakage.