Risk factors and preventive measures of anastomotic fistula after laparoscopic sphincter preserving surgery with low rectal cancer
10.3969/j.issn.1005-6483.2017.07.017
- VernacularTitle:腹腔镜低位直肠癌保肛术后吻合口瘘的危险因素分析及预防对策
- Author:
Jing QIN
- Keywords:
laparoscopic;
low rectal cancer;
anastomotic leakage
- From:
Journal of Clinical Surgery
2017;25(7):531-533
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors and prevention methods of anastomotic fistula after laparoscopic sphincter preserving surgery for low rectal cancer.Methods 166 patients with low rectal cancer were treated with laparoscopic total mesorectal excision(TME),34 cases were treated with prophylactic colostomy.The clinical and pathological factors were collected and the χ2 test was used to analyze the influencing factors of anastomotic leakage.Logistic regression analysis was used to analyze the independent risk factors of postoperative anastomotic leakage.Results Anastomotic leakage occurred in 14 cases,incidence rate was 8.43%(14/166).All patients were cured after conservative treatment.Univariate analysis showed that age(>65 years),basic diseases,preoperative albumin(<35 g/L),preoperative intestinal obstruction,tumor size(>4cm),Dukes stage were the risk factors of anastomotic leakage(P<0.05).Multivariate analysis showed that preoperative albumin,preoperative intestinal obstruction,tumor size were the independent risk factors of anastomotic fistula.Conclusion The incidence of anastomotic leakage in low rectal cancer was higher,should be highly valued.Prophylactic stoma should be used for the independent risk factors,which can effectively reduce the probability of the second operation,reduce the degree of fistula,shorten the healing time of fistula.
