Analysis Of Risk Factors For Perioperative Complications After Radical Resection Of Rectal Cancer

Objective: To analyze the risk factors of perioperative complications in rectal cancer patients undergoing radical resection.This study analyzed the risk factors of perioperative complications in patients undergoing radical resection of rectal cancer,so as to guide clinical work and reduce the incidence of perioperative complications.Methods: A total of 471 patients with rectal cancer who underwent radical resection from December 2009 to September 2013 in The First Affiliated Hospital of DalianMedical University were selected as the subjects of this study.By collecting clinical data during hospitalization(including gender,age,physical examinations during hospitalization,laboratory examination results,various complications,postoperative pathological data,etc.),chi-square test and Logistic multivariate regression analysis were conducted on the influencing factors of perioperative complications in patients undergoing radical resection of rectal cancer.Results: After screening,383 cases of rectal cancer were included in this study,including 236 cases(61.62%)of male patients and 147 cases(38.38%)of female patients,aged 28~93 years(median age 64 years).Perioperative complications were 89cases(23.24%).Of 24 cases of Pulmonary Infection(6.27%),Abdominal Cavity Infection in 11 cases(2.87%),12 cases(3.13%)of Infection of Incision,Under Urinary Tract Infection in 8 cases(2.09%),the fat liquefaction of incision in 7 cases(1.83%),Anastomotic Fistula in 5 cases(1.31%),Anastomotic Bleeding in 2 cases(0.52%),Postoperative Dysuria in 4 cases(1.04%),Postoperative leus in 5 cases(1.31%),3 cases(0.78%)of Acute Myocardial Infarction(AMI),Acute Pulmonary Embolism in 2 cases(0.52%),incision Dehiscence in 2 cases(0.52%),Acute ancreatitis with Acute Cholecystitis: 1 case(0.26%),Cardiogenic Shock: 1 case(0.26%),Cerebral Infarction: 1 case(0.26%),There was 1 case(0.26%)of Left Heart Failure,and no perioperative death was found in the whole group.The AJCC/UICC TNM staging system for colorectal cancer(8th edition,2017)was used for pathological staging.Logistic multivariate regression analysis showed that age ? 65(OR:0.651,95%CI :0.533 ~ 0.892,P=0.041),BMI? 24kg/?(OR:2.317,95%CI :1.352 ~ 3.57,P=0.001),preoperative serum albumin <35g/L(OR:0.836,95%CI :0.641 ~ 0.973,P=0.005)were independent risk factors for perioperative complications in patients undergoing radical resection of rectal cancer.Age?65(OR:0.617,95%Cl:0.415 ~ 0.802,P=0.001),history of smoking(OR:1.527,95%Cl:1.236 ~ 1.834,P=0.003),intraoperative blood loss ? 300ml(OR:1.527,95%CI:1.026 ~ 2.338,P=0.005)are independent risk factors for perioperative pulmonary infection in patients undergoing radical rectal cancer surgery.Age ? 65(OR:0.583,95%CI: 0.374 ~ 0.892,P=0.013),preoperative hemoglobin < 100g/L(OR:0.427,95%CI :0.1822 ~ 0.982,P=0.037),and intraoperative blood loss ? 300ml(OR:0.623,95%CI:0.437 ~ 0.872,P=0.001)were independent risk factors for perioperative abdominal infection in patients undergoing radical resection of rectal cancer.Conclusion:1)Advanced age,obesity,hypoalbuminemia are risk factors for perioperative complications in patients undergoing radical resection of rectal cancer.2)Advanced age,smoking history and excessive intraoperative blood loss are risk factors for perioperative pulmonary infection in patients undergoing radical resection of rectal cancer;3)Advanced age,hypoalbuminemia and excessive intraoperative blood loss are risk factors for peritoneal infection in patients undergoing radical resection of rectal cancer.