Screening Of Related Risk Factors And Treatment For Anastomotic Fistula After Rectal Tumor Resection

Objective:To explore the risk factors of anastomotic fistula after radical resection of rectal cancer in the Second Affiliated Hospital of Nanchang University,and to strengthen the understanding of risk factors in order to reduce the incidence of postoperative anastomotic fistula by perioperative intervention of risk factors,Reduce the economic burden of patients,shorten the hospital stay.Methods:A retrospective analysis was conducted on 386 patients undergoing radical resection of rectal cancer from January 2013 to March 2017 at the Second Affiliated Hospital of Nanchang University.The data were analyzed by SPSS 19.0 software.Single factor was analyzed by ? 2 test.Multivariate analysis was performed by unconditional logistic regression analysis.Results:27 cases of anastomotic fistula patients,12 patients by taking fasting,regulating water and electrolyte balance,anti-infection,strengthen nutritional support,repeated drainage of the sacral drainage tube and other measures,fistula gradually closed.6cases of anastomotic fistula patients drainage tube smooth,after eating did not cause fever,abdominal pain,abdominal distension and other discomfort,patients with drainage tube discharged,2-14 days after the return visit to see the abdominal wall sinus formation,removal of drainage tube,continue to strengthen nutritional support,Keep the stool dry,fistula gradually closed.4 cases of rectovaginal fistula patients,1case due to fistula small,less from the vaginal drainage fluid,after a positive anti-infection,enteral nutrition support,to correct water and electrolyte disorders and other measures to reduce the fistula edema,colposcopy fist In the colposcopy sutured fistula,review the fistula healing;the remaining 3 cases of vaginal leakage of fecal substances more,consider the vaginal uterine infection,nursing inconvenience,fistulaclosed their own small,in the strengthening of nutritional support,After transvaginal treatment,transvaginal stenosis was performed.Transvaginal colostomy and colonoscopy were performed 3 to 6 months after transvaginal ostomy.Two cases of vaginal fistula were closed.One patient underwent excision of the fistula,Mouth,and then after three months review fistula closed.4 patients after fasting,repeated anti-infection,nutritional support and drainage tube rinse treatment,the effect is not obvious,still repeated fever abdominal distension and other discomfort,the ileum single cavity ostomy,postoperative fever abdominal pain bloating symptoms improved,,3 months after surgery to check the colonoscopic fistula has been closed.1 case of tumor stage later,has been infiltrating the bladder tissue,rectal cancer radical resection 7 days after rectal bladder fistula,urinary tract infection,and immediately transverse stromal ostomy,postoperative fasting,active anti-infection and nutrition and other symptomatic Support the treatment after the smooth discharge,six months back to the hospital review fistula has been healed.Conclusion:Age,preoperative neoadjuvant therapy,the distance between the lower edge of the tumor from the anus is less than 7 cm,preoperative intestinal obstruction,tumor staging for rectal cancer radical anastomotic fistula after the risk factors,attention to perioperative risk Factor screening,assessment and treatment,according to the preoperative assessment of the appropriate choice of surgical methods,according to the specific circumstances of the development of individual treatment programs to achieve the best therapeutic effect.