Analysis Of Influencing Factors Of Anastomotic Leakage In Elderly Patients Undergoing Laparoscopic Radical Resection Of Rectal Cancer

Objective:The influencing factors of anastomotic leakage after laparoscopic radical resection of colorectal cancer in the elderly aged 60 and abrove were analyzed,so as to provide theoretical support and help for reducing or avoiding the incidence of postoperative anastomotic leakage.Methods:In this study,a retrospective analysis was used to conduct a univariate and multivariate regression analysis on the clinical data of 110 elderly patients admitted to the gastrointestinal surgery department of the first affiliated hospital of xiamen university and underwent laparoscopic-assisted radical resection of rectal cancer from January 2017 to January 2019.Specific analysis factors include gender,whether diabetes mellitus,whether hypertension,body mass index(BMI),preoperative preoperative anesthesia risk score,preoperative albumin content,preoperative hemoglobin content,preoperative CEA content,whether preoperative intestinal obstruction,whether preoperative neoadjuvant chemoradiation,whether preventive colostomy,the distance from the anastomosis to the anal margin,the distance from the lower margin of the tumor to the anal margin,operation time,whether intraoperative presence of reserves left colic artery,whether to indwelling the anal canal during the operation,whether to strengthening the anastomotic site,the maximum diameter of tumor and the pathological stage of tumor.Results:Among 110 elderly patients who met the inclusion criteria,7 patients with anastomotic leakage occurred after laparoscopic radical resection of rectal cancer,with an incidence of 6.36%.The results of chi-square test showed that:preoperative hypoalbuminemia,preoperative anemia,the distance between the lower margin of the tumor and the anus being 5-7cm,the maximum diameter of the tumor>4cm were correlated with the incidence of anastomotic leakage in the elderly after laparoscopic rectal cancer surgery,P<0.05,and the difference was statistically significant.Whether gender,whether diabetes mellitus,hypertension,body mass index(BMI),preoperative preoperative anesthesia risk score,the CEA preoperatively,presence of intestinal obstruction in the preoperative,whether preoperative neoadjuvant chemoradiation,whether preventive colostomy,anastomotic anal edge distance,operation time,intraoperative reserves left colic artery,in presence of anal canal lien,in presence of strengthening anastomotic,tumor staging the old line of laparoscopic colorectal cancer has no obvious correlation between postoperative anastomotic leakage happened.The results of multivariate regression analysis showed that the incidence of anastomotic leakage after laparoscopic rectal cancer surgery in elderly patients with preoperative hypoalbuminemia,preoperative anemia,and the distance between the lower margin of the tumor and the anus was 5-7cm had a close correlation,P<0.05,and the difference was statistically significant.Conclusion:1.Among the elderly patients undergoing laparoscopic radical resection of rectal cancer,four factors were associated with the occurrence of postoperative anastomotic leakage:preoperative hypoalbuminemia,preoperative anemia,the distance between the lower margin of the tumor and the anus being 5-7cm,and the maximum diameter of the tumor>4cm.2.In elderly patients undergoing laparoscopic-assisted radical resection of rectal cancer,the risk of postoperative anastomotic leakage will be increased by three factors:preoperative hypoalbuminemia,preoperative anemia,the distance between the lower margin of the tumor and the anus being 5-7cm.