Risk factors of anastomotic leakage and its significance on the survival of rectal cancer patients after low anterior resection
10.3760/cma.j.issn.1007-631X.2010.06.001
- VernacularTitle:直肠癌术后吻合口瘘的危险因素及对预后的影响
- Author:
Jing YAO
;
Xiaodong HAN
;
Yu WANG
- Publication Type:Journal Article
- Keywords:
Rectal neoplasms;
Fistula;
Risk factor;
Survival rate
- From:
Chinese Journal of General Surgery
2010;25(6):433-435
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.
