Analysis And Prevention Measures About Postoperative Anastomotic Fistula Related Factors Of Colorectal Cancer By TME

BackgroundColorectal cancer (rectal cancer) sector in the sigmoid colon and rectum cancer dentate line to the junction between the middle and lower colorectal cancer is more common in China, accounting for79%, changing the standard of living and diet of the people, so that the incidence of showed a gradual increasing trend year by year, and has been dropping; optimal treatment approach is surgical resection,1982, total mesorectal excision (TME)[1] the concept was first proposed by Heald, etc., along with improved surgical techniques perfect, and confirmed its low colorectal cancer can effectively increase sphincter preservation rate and reduce the local recurrence rate was significantly improved long-term survival, most patients can be implemented sphincter preserving surgery, postoperative anastomotic fistula is an important prognostic factor, but also the surgical a long-term task facing doctors.ObjectiveExplore the risk factors for colorectal cancer surgery resulted in about anastomotic leakage arising explain the pathophysiology and prevention of its occurrence and treatment approaches, and establish a theoretical basis for clinical prevention and reduce the incidence of anastomotic fistula, thereby reducing the mortality, physical trauma economic burden, improve quality of life.Subjects and MethodsFor January2011to January2013received treatment in187cases of colorectal cancer patients Second Affiliated Hospital of Dalian Medical University, clinical data, systematicretrospective analysis, the implementation of its colorectal cancer total mesorectal excision(TME) surgical procedures a total of125cases, and the establishment of a database. SPSS17.0statistical analysis software application. The results showed: age, preoperative Hgb,ALB, diabetes, distance from the anal anastomosis, preoperative obstruction, preoperativeadjuvant chemotherapy, lined stump suture line, postoperative pelvic infection of anastomoticleak related risk factors.Result18cases of anastomotic leakage occurred in this group of patients, the experimentalstatistics TME anastomotic line colorectal cancer rate of about14.4percent, its occurrencemay be due to patient baseline, intraoperative factors, anastomotic local conditions,postoperative complications and secondary treatment and other factors interacting chainreaction. Merger hypoproteinemia, anemia, chronic obstructive pulmonary disease, diabetesand other diseases should improve preoperative preparation, fine operation, postoperativeearly diagnosis and treatment, sum up experience and lessons learned, taking individualizedtreatment plan, can significantly improve the long-term prognosis and quality of life.Conclusion1, baseline factors in patients, surgery operation, anastomotic local conditions,postoperative complications are risk factors associated with postoperative anastomotic fistulaTME impact.2, supported by preoperative treatment, bowel preparation, meticulous surgicaloperation, postoperative patency TME drainage, etc. can be effective in preventing thedevelopment of postoperative anastomotic fistula.3, to conservative treatment, surgical treatment according to the patient’s own individualprograms, treatment and prevention of anastomotic leak and its complications.