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

Objective:To explore the risk factors associated with anastomotic leakage after anterior resection for rectal cancer, provide a useful reference for clinical prevention and treatment of anastomotic leakage, reduce the incidence of anastomotic leakage and reduce the suffering of patients and improve the quality of life of patients.Methods:Collected the clinical data about anterior resection for rectal cancer (Dixon surgery) clinical data of463cases,38patients with anastomotic leakage, from January2008to March2013at the First Hospital of Lanzhou University. Retrospective analysis the risk factors could lead to anastomotic leakage, it can be divided into anastomotic leakage and no anastomotic leakage group, using SPSS19.0statistical software package for data analysis, use the card square test, with P<0.05was considered statistically significant difference.Results:The group of463cases of patients with anastomotic leakage occurred in38cases, the incidence rate was8.21%, the average time of onset about anastomotic leakage was4.8(2-10) days, with no deaths. Statistical analysis showed that the postoperative diarrhea, tumor pathologic stage, tumor position, and preoperative complications such as hypoalbuminemia, diabetes, and intestinal obstruction affects the incidence of anastomotic leakage, Those factors have higher incidence than others, Statistical analysis showed that they have statistically significant differences(P<0.05), can be considered as risk factors influence colorectal cancer of anastomotic leakage. Another risk factors such as patient gender, the age and tumor size although no statistical significance(P>0.05), but there are significant differences in the incidence, so we can believe that these factors has certain influence on the occurrence of anastomotic leakage, but these factors are not the determining factors of anastomotic leakage. Whether to use anastomat in the surgery had no effect on the incidence of anastomotic leakage, the difference was not statistically significant(P>0.05). Most of the patients with anastomotic leakage (35cases, accounting for92.11%) have been effectively controlled by conservative treatment concluded such as drainage tube drainage, antibiotics and nutritional symptomatic support and so on. Their average healing time was10.7(7-14) days, and discharged smoothly. At the same time, their have3patients (7.89%) go to Operating Room for exploratory laparotomy or temporary transverse colostomy, though symptomatic and supportive treatment received recovered and leave hospital. Their average healing time was25.3days (22to28).Conclusions:Anastomotic leakage after anterior resection for rectal cancer associated with multiple risk factors. Postoperative diarrhea, tumor pathologic stage, tumor location and preoperative complications such as hypoalbuminemia, diabetes, and intestinal obstruction are risk factors influencing anastomotic leakage. Patients’age, sex, tumor size has a smaller effect on anastomotic leakage. Whether to use anastomat in the surgery has no effect on the incidence of anastomotic leakage. For these risk factors, we should actively correct preoperative complications, carefully and prudently operation, early postoperative diagnosis and treatment, which can effectively improve the quality of life of patients.