Correlation between intestinal flora imbalance and anastomotic leakage after operation for middle to low rectal cancer
10.19538/j.cjps.issn1005-2208.2019.07.14
- Author:
Xiao-qiang XUE
1
;
Xue-shan BAI
;
Guo-le LIN
1
Author Information
1. Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730,China
- Publication Type:Journal Article
- Keywords:
mid-low rectal cancer;
intestinal flora imbalance;
anastomotic leakage;
low anterior resection
- From:
Chinese Journal of Practical Surgery
2019;39(07):698-703
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To analyze the risk factors and relationship between intestinal flora imbalance and anastomotic leakage after laparoscopic rectal cancer lower anterior resection(LAR)in patients with middle-low rectal cancer.METHODS: Clinical data of 155 patients with mid to low rectal cancer who underwent laparoscopic lower anterior resection at Peking Union Medical College Hospital from November 2016 to April 2019 were retrospectively analyzed.Postoperative intestinal flora imbalance and anastomotic leakage were evaluated,and statistical results were gained.RESULTS: Of the 155 patients,34(21.9%)patients had postoperative intestinal flora imbalance. Twenty patients of anastomotic leakage after operation(12.9%)were discovered,and 18 patients(11.6%)had both anastomotic leakage and intestinal flora imbalance. Univariate and multivariate logic regression analysis showed that intestinal flora imbalance(χ~2=25.674,OR=90.398,P<0.05)and the increase of tumor diameter(χ~2=6.644,OR=6.780,P<0.05)were risk factors for anastomotic leakage after operation. Protective enterostomy can reduce the risks of anastomotic leakage(χ~2=4.040,P=0.044;P<0.05) when compared with non-stoma surgery. There was no statistical significance for intestinal flora imbalance in tumor diameter,distances from above the anal verge to tumor,neoadjuvant chemoradiotherapy,preoperative serum albumin level,intestinal preparation dosage,preoperative CEA level,operation time and intraoperative bleeding volume(P>0.05).CONCLUSION: The early diagnosis of postoperative intestinal floraimbalance in rectal cancer patients depends more on clinical experience. Intestinal floraimbalance,the enlargement of tumor diameterare risk factors for anastomotic leakage,and protective enterostomy would reduce the incidence of anastomotic leakage.
