Analysis Of Related Factors Of Anastomotic Leakage After Rectal Cancer Dixon Operation

Objective:Anastomotic leakage(AL)after Dixon surgery in patients with rectal cancer(RC)is one of the common complications of the operation,which has a serious impact on the patient's postoperative recovery,not only greatly extend the patient's hospital stay,but also increasing the patient's medical burden.It can even endanger life.Therefore,it is important to reduce the incidence of postoperative anastomotic leakage.In this study,the clinical data of 189 patients were used to investigate the related factors of anastomotic leakage.Methods:The data of 189 patients with rectal cancer who underwent Dixon surgery at the Department of Colorectal Anal Surgery,Shanxi Provincial Tumor Hospital from February 2017 to December 2017 were summarized and analyzed.The relationship between anastomotic leakage and multiple factors,such as age,gender,operation time,diabetes mellitus(DM),the preoperative immune function,degree of tumor differentiation,whether the staple anastomosis after the anastomosis,the surgical approach,the distance from the anus to the anastomosis,and whether there is a long-term history of glucocorticoid(GC),was analyzed by univariate analysis,P<0.05 was statistically significant.Statistically significant univariate variables were analyzed by Binary Logistic Regression Analysis,P<0.05 was statistically significant.Results:(1)Among the 189 patients,there were 15 anastomotic leaks after surgery,accounting for 7.9%.There was no correlation between the incidence of anastomotic leakage and the following factors,age(P=0.790),gender(P=0.723),operation time(P=0.779),degree of tumor differentiation(P=0.466),immune function(P=0.823),the surgical approach(P=0.964).In contrast,DM(P=0.013),whether the staple anastomosis after the anastomosis(P=0.040),the distance from the anus to the anastomosis(P=0.010),and whether there is a long-term history of glucocorticoid(P<0.001)were related to the occurrence of anastomotic leakage.(2)Taking the anastomosis leakage as the dependent variable,the above four significant factors were analyzed by Binary Logistic Regression Analysis.The results showed that DM(?=2.666,OR=14.382,95% CI:2.534-81.643,P=0.003),the distance from the anus to the anastomosis(?=2.684,OR=14.640,95%CI:2.444-87.681,P=0.003),whether the staple anastomosis after the anastomosis(?=1.797,OR=6.034,95% CI:1.507-34.435,P=0.043).Whether there is a long-term history of GC(?=5.767,OR=319.654,95% CI:12.533-8152.799,P<0.001)was an independent risk factor for anastomotic leakage.Conclusion:There was no correlation between the incidence of anastomotic leakage and the following factors,age,gender,operation time,degree of tumor differentiation,immune function,the surgical approach.In contrast,DM,whether the staple anastomosis after the anastomosis,the distance from the anus to the anastomosis,and whether there is a long-term history of glucocorticoid were related to the occurrence of anastomotic leakage.And the above four significant factors was an independent risk factor for anastomotic leakage.The occurrence of anastomotic leakage is associated with a variety of factors.Clinicians should take active measures during the perioperative period to prevent anastomotic leakage.Once anastomotic leaks occur,active measures should be taken to treat them,and conservative treatment or surgical treatment options should be properly selected to promote early recovery.