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| Analysis of the influence of reinforced anastomosis on anastomotic fistula after laparoscopic anus-preserving operation for middle and low rectal cancer and its factors |
| LI Zhen-sheng1 WANG Chun-peng2 CHEN Ruo-bing3 |
1.Department of Surgery,Liaoyang City Hospital,Liaoning Province,Liaoyang 111000,China;
2.Department of Health Management,Liaoning Medical Vocational College,Liaoning Province,Shenyang 110101,China;
3.Department of Nursing,Liaoning Medical Vocational College,Liaoning Province,Shenyang 110101,China |
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Abstract Objective To investigate the influence of laparoscopic anastomotic reinforcement on the occurrence of anastomotic fistula in patients with middle and low rectal cancer and the related factors of anastomotic fistula.Methods A total of 201 patients with middle and low rectal cancer undergoing anus preserving surgery in Liaoyang Central Hospital from June 2017 to December 2019 were selected as the research subjects.According to random number table method,they were divided into routine anastomosis group (100 cases) and reinforced anastomosis group (101 cases).The incidence and occurrence time of postoperative anastomotic fistula,operative time,intraoperative blood loss,time of postoperative exhaust and time of postoperative feeding were compared between the two groups,and the related factors of anastomotic fistula were analyzed.Results The incidence of anastomotic fistula in the reinforced anastomotic group was lower than that in the conventional anastomotic group,and the operation time was longer than that in the conventional anastomotic group,the differences were statistically significant (P＜0.05).There were no statistical significances in the occurrence time of anastomotic fistula,intraoperative blood loss,postoperative exhaust time and feeding time between the two groups (P＞0.05).Univariate analysis indicated that the anastomotic fistula group and the group without anastomotic fistula showed statistically significant differences in the anastomotic method,age,history of diabetes,history of hypertension and history of chemotherapy (P＜0.05).Multivariate analysis indicated that the history of chemotherapy (β=1.358,OR=3.889,95%CI 1.160-13.040),age≥50 years old (β=0.100,OR=1.105,95%CI 1.005-1.214) and routine anastomotic operation (β=1.948,OR=7.017,95%CI 2.220-22.183) were risk factors for postoperative anastomotic fistula in patients with moderate and low rectal cancer (P＜0.05).Conclusion Reinforcement anastomosis after laparoscopic anastomosis can reduce the occurrence of anastomotic fistula.Age≥50 years old and the history of chemotherapy and conventional anastomosis are the main risk factors for anastomotic fistula.
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