| Objective:to identify risk factors for anastomotic leakage in transabdominal resection of rectal cancer (Dixon operation for rectal cancer)Methods:The clinical date of596rectal patients underwent transabdominal resection of rectal cancer (Dixon operation for rectal cancer) in Shandong Province Hospital from2010.10to2013.10are collected and retrospectively analyzed. Reorganizing these data and establish the database. Then using statistical knowledge to analyze possibly risk factors of anastomotic leakage after operation.Results:In596patients,46cases symptomatic clinically evident anastomotic leakage occured after transabdominal resection of rectal cancer, accounted for7.7%. The rate of anastomotic leakage in male patients was8.2%(30/364), the rate of anastomotic leakage in female patients was6.9%(16/232); The rate of anastomotic leakage in patients over65years old was7.7%(30/390), the rate of anastomotic leakage in patients less than65years old was6.8%(16/206); The rate of anastomotic leakage in patients with a history of smoking was8.1%(20/246), the rate of anastomotic leakage in patients without the history of smoking was7.2%(26/350); The rate of anastomotic leakage in diabetic was16.1%(9/56), the rate of anastomotic leakage in patients without diabetes was7.1%(37/540); The rate of anastomotic leakage in patients with preoperative anemia was11.3%(13/115), the rate of anastomotic leakage in patients without anemia was6.9%(33/481); The rate of anastomotic leakage in patients with the distance between inferior margin of tumor to the anal over7cm was4.3%(8/187), the rate of anastomotic leakage in patients with the distance between inferior margin of tumor to the anal below7cm was9.3% (38/409); The rate of anastomotic leakage in patients with a intensive suture after instrument anastomosis was3.8%(6/157), the rate of anastomotic leakage in patients without a intensive suture after instrument anastomosis was9.1%(40/439); The rate of anastomotic leakage in patients with hand-assisted laparoscopic rectectomy was7.0%(15/213), the rate of anastomotic leakage in patients with the laparoscopic assisted rectectomy was6.6%(13/196), the rate of anastomotic leakage in patients with open rectectomy was9.6%(18/187); The rate of anastomotic leakage in patients whose operation time was over3h was7.5%(26/348), the rate of anastomotic leakage in patients whose operation time was lessthan3h was8.1%(20/248); The rate of anastomotic leakage in patients who were indicated highly differentiated was6.5%(7/108), the rate of anastomotic leakage in patients who were indicated moderately differentiated was6.2%(17/275), the rate of anastomotic leakage in patients who were indicated low differentiated was10.3%(22/213); The rate of anastomotic leakage in patients with lymph node metastasis was8.5%(29/340), the rate of anastomotic leakage in patients without lymph node metastasis was6.6%(17/256).Conclusion:according to the result of data analysis, differences in age and gender, preoperative anemia, a history of smoking or not, the differences in modus operandi, duration of operation, the degree of tumor differentiation, lymph node metastasis or not had no significant correlation with the occurring of postoperative anastomotic leakage, but the patients who had the history of diabetes or not, the distance between inferior margin of the tumor and the anus, intensive suture after instrument anastomosis or not had significant correlation with the occurring of postoperative anastomotic leakage. |
