Analysis Of Risk Factors For Benign Anastomotic Stenosis After Laparoscopic Colorectal Cancer Operation

Objective:Retrospective analysis of 328 cases of colorectal cancer patients with postoperative anastomotic stricture incidence and related independent risk factor..Method:496 cases of colorectal cancer diagnosed from Zhengzhou University People's Hospital(Henan Provincial People's Hospital)were collected from May 2016 to October 1818.The clinical and pathological data were summarized and the inclusion criteria and exclusion criteria were formulated.Patients who met the study criteria were included in the analysis and retrospectively analyzed the perioperative risk factors associated with postoperative anastomotic stenosis in patients with colorectal cancer.The data were calculated and analyzed by SPSS22.0 software.The comparison between groups was applied to the test c 2(Fisher's exact test if necessary).The statistically significant variables were analyzed by univariate analysis.The multivariate analysis was performed by using ordered logistic regression.The statistical results were statistically significant with p<0.05.Results:(1)A total of 328 patients with colorectal cancer were included in the analysis.There were 196 males and 132 females with a median age of 48 years(range,22-77years).The median distance of the tumor from the anal margin was 8 cm(range 3-16).cm).All patients underwent a radical operation,and the position of the anastomosis was at the level below the peritoneal reentry.All patients had no deaths after 30 days of surgery;(2)36 patients(36/328,10.9%)had anastomotic stenosis.The median time from initial surgery to anastomotic stenosis was 7.5 months(1-23 months).According to the criteria,there were 11 cases of II degree,8 cases of III degree,and 17 cases of IV degree.Symptomatic stenosis occurred in 15 patients(41.6%),such as difficulty in defecation(11/ 15,73.3%),abdominal distension(9/15,60.0%),and abdominal pain(7/15,46.6%),while the remaining patients(21/)36,58.3%)without any symptoms associated with stenosis;(3)Univariate analysis showed that anastomotic stenosis occurred after colorectal surgery were related to type of anastomotic device,the distance from anal margin to anastomosis,diverting stoma,perioperative radiotherapy,postoperative abdominal infection,postoperative anastomotic leakage,First meal time after surgery over 5 days(p<0.05);(4)Multivariate analysis showed that the distance from anal margin to anastomosis,diverting stoma,postoperative anastomotic leakage,and perioperative radiotherapy were independent risk factors for anastomotic stenosis after colorectal surgery(p<0.05).Conclusion:(1)This study showed that the distance from the anastomosis to the anal margin is less than 7cm,diverting stoma,postoperative anastomotic leakage,and Neoadjuvant chemoradiation were independent risk factors for anastomotic stenosis after colorectal cancer surgery.