Clincal Investigation About The Risk Factors Of Anastomotic Leakage After Anterior Resection Of Rectal Cancer

Objective To analyze the risk factors of anastomotic leakage after resection of rectalcancer,explain the pathophysiological mechanisms,and establish a scoring system toguide clinical practiceMethod A retrospective study of 297 patients received rectal cancer Dixonsurgery from January 2012 to Septmeber 2016 in our hospital.There are 293 patients who accordance with the inclusion criteria received operation of preserving anal sphincter,28 patients had an anastomotic leakage.The patient were divided into: no complications group which has 265 cases of group(90.4%)and complications group which has 28 case of group(9.6%).We collect the data about the patient,such as the patients' age,and anal edge distance,TNM staging and preoperative diabetes mellitus,preoperative obstruction and exhaust time,preoperative albumin,tumor size,gender,hypertension,neoadjuvant chemotherapy,preventive colostomy,surgical procedure,postoperative bed time.Made x2 test and Logistic regression analysis to identify the risk of anastomotic leakage.And the difference is valuable when P <0.05.Result Univariate analysis show that the patients' age,and anal edge distance,TNM staging and preoperative diabetes mellitus,preoperative obstruction and exhaust time,preoperative albumin,tumor size difference was statistically significant.The no complications group's anal edge distance is distance,(7.40±3.42)cm vs(6.20±2.44)cm,Preoperative albumin of the no complications group is higher than complications group,(38.9±5.2)g/L vs(36.4±4.87)g/L,Evacuation time of the no complications group is shorter than complications group,(4.45±1.08)d vs(4.86)d,the no complications group's tumor size is smaller,(5.63±0.98)cm vs(6.81±0.81)cm.There was no statistically significant difference factors of gender,hypertension,neoadjuvant chemotherapy,preventive colostomy,surgical procedure,postoperative bed time.Logistic regression analysis showed that TNM staging,diabetes mellitus,preoperative obstruction,exhaust time,tumor size was the independent risk factors of postoperative anastomotic fistula rectal cancer.Conclusion 1.The research show that age,and anal edge distance,TNM staging and preoperative diabetes mellitus,preoperative obstruction and exhaust time,preoperative albumin,tumor size is a risk factors for anastomotic fistula.And TNM staging,diabetes mellitus,preoperative obstruction,exhaust time,tumor size is the independent risk factors of postoperative anastomotic fistula rectal cancer.2.For the patients,such as infirm,advanced tumors,the low anastomotic location,preoperative neoadjuvant chemoradiation.The suggest preventive colostomy can significantly improve the prognosis of patients with anastomotic fistula.