Current status of influencing factors for postoperative anastomotic leakage in low rectal cancer.
10.3760/cma.j.cn441530-20220517-00218
- VernacularTitle:低位直肠癌术后发生吻合口漏影响因素的研究现状
- Author:
Ya Ting LIU
1
;
Yu HUANG
1
;
Yao Guang HAO
1
;
Peng Fei ZHANG
1
;
Xu YIN
1
;
Jian Feng ZHANG
2
;
Xu Hua HU
2
;
Bao Kun LI
2
;
Gui Ying WANG
3
Author Information
1. Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050051,China.
2. Department of The Second General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011,China.
3. Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050051,China Department of The Second General Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011,China.
- Publication Type:Journal Article
- MeSH:
Humans;
Male;
Anastomotic Leak/prevention & control*;
Rectum/surgery*;
Rectal Neoplasms/complications*;
Anastomosis, Surgical/adverse effects*;
Laparoscopy/adverse effects*
- From:
Chinese Journal of Gastrointestinal Surgery
2022;25(11):1039-1044
- CountryChina
- Language:Chinese
-
Abstract:
The incidence of anastomotic leakage, a common and serious postoperative complication of low rectal cancer, remains high. Clarifying the risk factors for anastomotic leakage in patients with low rectal cancer after surgery can help guide clinical treatment and help patients improve their prognosis. The current literature suggests that the risk factors affecting the occurrence of anastomotic leakage after low rectal cancer include three aspects: (1) individual factors: male gender, high body mass index, malnutrition, smoking, alcoholism, and metabolic diseases; (2) tumor factors: the lower margin of tumor <5 cm from the anal verge, tumor diameter >2.5 cm, late tumor stage, high level of tumor markers and preoperative intestinal obstruction; (3) surgical factors: long operative time (>180 min), intraoperative bleeding (≥70 ml), more than 2 cartridges of stapling for anastomosis, contamination of the operative field, epidural analgesia and intraoperative hypothermia. Notably, the surgical approach (laparoscopic, open and hand-assisted laparoscopic surgery) was not a factor influencing the occurrence of postoperative anastomotic leakage in low rectal cancer. The findings on the effects of receiving neoadjuvant therapy, gut microbiota,intestinal bowel preparation, insufficient time for preoperative antibiotic prophylaxis, left colonic artery dissection, intraoperative blood transfusion, pelvic drainage, transanal drainage and combined organ resection, and postoperative diarrhea on postoperative anastomotic leakage in low rectal cancer are controversial. However, clinical workers can still take measures to reduce the risk of anastomotic leakage according to the above risk factors by making a good assessment before surgery, actively avoiding them during and after surgery, and taking measures for each step, so as to bring maximum benefits to patients.
