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Analysis Of Risk Factors For Anastomotic Leakage After Laparoscopic Anterior Resection Of Rectal Cancer

Posted on:2020-04-12Degree:MasterType:Thesis
Country:ChinaCandidate:L WangFull Text:PDF
GTID:2404330572474936Subject:Surgery
Abstract/Summary:PDF Full Text Request
Objective:To retrospectively analyze the risk factors of anastomotic leakage after laparoscopic radical resection of rectal cancer,and find the methods to prevent and reduce the occurrence of anastomotic leakage after laparoscopic anterior resection of rectal cancer.Through preoperative risk factors assessment and treatment,can improve perioperative safety and promote the recovery of patients.Methods:A retrospective analysis was conducted on 252 patients undergoing laparosxopic anterior resection of rectal cancer from January 2015 to September 2017in the Dalian Central Hospital.The factors related to the occurrence of anastomotic leakage,such as sex,age,smoking,alcohol consumption,preoperative diabetes mellitus,admission albumin level,body mass index,nutritional risk assessment,DATV,preservation of LCA,degree of tumor differentiation,tumor diameter and TNM,anal drainage and other related factors were included in the analysis.The data were analyzed by SPSS 22.0 software.Univariate analysis was analyzed by ?~2 test.Multivariate analysis was performed by Logistic regression analysis.Results:(1)According to inclusion and exclusion criteria,a total of 252 cases were included in this study.24 cases of anastomotic leakage occurred after operation.The overall incidence of anastomotic leakage was 9.5%(24/252);(2)Univariate analysis showed that the occurrence of anastomotic leakage was correlated with sex,diabetes,distance of the tumor from the anal verge(DATV),preoperative hypoalbuminemia,and preservation of LCA(P<0.05);(3)Multivariate analysis showed that sex(OR=5.196,P=0.034),diabetes(OR=3.307,P=0.037),preoperative hypoalbuminemia(OR=4.117,P=0.016),nutritional risk assessment(OR=3.908,P=0.010)and DTAV(OR=4.117,P=0.016)were independent risk factors for anastomotic leakage after laparoscopic rectal cancer surgery(P<0.05).Conclusion:1.Sex,preoperative diabetes mellitus,preoperative hypoalbuminemia,nutritional risk assessment,DATV,and retention of LCA are the possible risk factors for postoperative anastomotic leakage;Sex,diabetes,preoperative hypoalbuminemia,DATV,were the independent risk factors of postoperative anastomotic leakage.2.According to preoperative risk factors assessment,basic diseases should be actively controlled in patients with high risk factors:male,old,malnutrition,preoperative diabetes mellitus and low rectal carcinoma.Adjusting the nutritional status of patients and observing abdominal signs and drainage are of great significance for the prevention and treatment of postoperative anastomotic leakage.
Keywords/Search Tags:rectal cancer, anastomotic leakage, risk factors
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