Analysis Of The Factors Affecting The Postoperative Anastomotic Leakage In Elderly Patients With Colon Cancer

ObjectiveThis article through the analysis of the data of 485 elderly patients with colon cancer and 18 cases of postoperative anastomotic leakage after general surgery 2013.01.01-2017.12.31 in our hospital,to explore the causes,diagnosis,late treatment,risk factors,and preventive measures of postoperative anastomotic leakage in elderly patients with colon cancer.MethodsThis article retrospectively analyzed 485 patients with colon cancer who were admitted to the hospital between January 1,2013 and December 31,2017.Among them,18 patients had anastomotic leakage after surgery.Four hundred and eighty-five patients with senile colon cancer undergoing anastomotic leakage were divided into study group18 and 467 patients as control group.Logistic regression analysis was performed for univariate and multivariate analysis for the two groups of patients.Compared gender,BMI,ECOG score,surgical methods,intraoperative blood loss,preoperative ileus,preoperative diabetes,hypoalbuminemia,tumor location,tumor differentiation,length of hospital stay,and ASA grade impact on postoperative anastomotic leakage.ResultsAnastomotic fistula occurred in 18 of 485 patients.The incidence was 3.7%.Among all the factors analyzed,gender,BMI,preoperative ileus,diabetes mellitus,and hypoalbuminemia were observed in both groups.There was a statistically significant difference in tumor location,ASA grade,and length of hospital stay(P<0.05).There was no significant correlation between BMI,surgical procedures,intraoperative blood transfusion volume,ECOG score,and tumor differentiation.Multivariate regression analysis showed that gender,hypoalbuminemia,preoperative intestinal obstruction,diabetes mellitus,tumor location,and ASA grade were independent risk factors for the occurrence of anastomotic leakage in patients(P<0.05).ConclusionThe elderly patients with colon cancer have unique clinical characteristics.The independent risk factors for postoperative anastomotic leakage in elderly patients with colon cancer are gender,preoperative ileus,combined diabetes,hypoproteinemia,tumor location,ASA grading.Conservative treatment is the first choice for treatment,and preoperative preparation should be completed as much as possible before the operation;diet should be completely banned during the acute phase,and a slag-free diet should be carried out after complete parenteral nutrition.Recovering the intestine diet as soon as possible is conducive to recovery.