Exploring the multi-factors and preventive measures affecting anastomotic leakage after laparoscopic radical resection of rectal cancer

Abstract

Objective To investigate the multi-factors and preventive measures of anastomotic leakage after laparoscopic radical resection of rectal cancer. Methods A retrospective study on 98 cases of patients with rectal cancer who were admitted and underwent laparoscopic radical resection from January 2016 to November 2018.There were 50 cases of male, 48 cases of female, aged(50.12 ± 4.95)years old, ranged from 42 to 81 years old.The 8 cases of patients with postoperative anastomotic leakage were divided into the anastomotic leakage group, the other 90 cases of patients without postoperative anastomotic leakage were divided into the anastomotic leakage group.Logistic regression analysis was used to analyze and summarize the influence factors of postoperative anastomotic leakage in laparoscopic rectal cancer. Results The anastomotic leakage group had a higher proportion of patients with anastomotic plane than the anal margin ≤ 5 cm, body mass index(BMI)index ≥ 24 kg/m2, and operation time ≥ 210 minutes.The proportion of patients with anastomotic leakage [75.0%(6/8), 62.5%(5/8), 62.5%(5/8)]were higher than those in the not anastomotic leakage group[24.4%(22/90), 18.9%(17/90), 21.1%(29/90)], and the difference between the two groups was statistically significant(P<0.05). Univariate analysis showed that the anastomotic plane was ≤5 cm from the anal margin, the BMI index was ≥24 kg/m2, and the operation time was ≥210 minutes, which was a risk factor for anastomotic leakage.The above three factors were included in the multivariate logistic regression analysis.The results showed that the anastomotic plane was ≤5 cm from the anal margin, the BMI was ≥24 kg/m2, and the operation time was ≥210 min, which could be used as an independent risk factor for anastomosis. Conclusion The anastomosis distance from the anus, body mass index, and operation time can be used as risk factors for anastomotic leakage after laparoscopic radical resection of rectal cancer.Effective preventive measures should be taken to reduce the occurrence of postoperative anastomotic leakage. Key words: Laparoscopy; Rectal cancer; Postoperative anastomotic leakage; Risk factors; Preventive measures