Clinical Investigation About The Risk Factors Of Gastric Cancer Postoperative Anastomotic Fistula

?Objective?To study anastomotic fistula of the gastric cancer patients after the gastrectomy and analyze the risk factors so as to provide clinical predictors anastomotic fistula.?Methods?The clinical data of 425 gastric cancer patients from The first affiliated hospital of fujian medical university who underwent surgery from Dec 2012 to Dec 2017 were retrospectively analyzed.The gender,age,BMI,Preoperative serum albumin levels,Preoperative chemotherapy,Operation method,anastomotic way,Tumor invasion of cardia,operation time,TNM-staging,blood loss during operation,complicated diabetes was analyzed.According to whether there is anastomotic fistula,divided into anastomotic fistula group 43 cases,non-anastomotic fistula group 382 cases.Analysis of differences between groups and between different indicators.and conduct Logistic regression analysis for single factor and multiple factors of anastomotic fistula of the gastric cancer patients after the gastrectomy.All the data with SPSS24.0 software for statistical analysis.?Results?There were 43 cases(10.1%)with anastomotic fistula among 425 patients tread by gastric cancer operation.The analysis of single factor showed that: The incidence of anastomotic fistula of the gastric cancer patients after the gastrectomy has statistical significance(P < 0.05)in the difference between such factors: BMI,Preoperative chemotherapy,Operation method(Total gastrectomy),Tumor invasion of cardia,blood loss during operation(?400ml).while there has no statistical significance(P > 0.05)in the differences between The gender,age,Preoperative serum albumin levels,anastomotic way,operation time,TNM-staging,complicated diabetes.Multiple factors logistic analysis showed: Preoperative chemotherapy,Tumor invasion of cardia,blood loss during operation(?400ml)are relatively independent risk factors of anastomotic fistula of the gastric cancer patients after the gastrectomy.?Conclusions?1.BMI,Preoperative chemotherapy,Operation method(Total gastrectomy),Tumor invasion of cardia,blood loss during operation(?400ml)and other factors is related risk factors of anastomotic fistula of the gastric cancer patients after the gastrectomy.2.Preoperative chemotherapy,Tumor invasion of cardia,blood loss during operation(?400ml)is relatively independent of the risk factors of anastomotic fistula of the gastric cancer patients after the gastrectomy.3.Preoperative clear tumor staging,careful operation and prompt blood transfusion can reduce the occurrence of anastomotic leakage after gastric cancer.4.The timely and smooth drainage,anti-infection and nutritional support treatment are the keys to postoperative anastomotic leakage in gastric cancer.