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| Analysis on risk factors of anastomotic fistula after rectal cancer surgery |
| 耿宣 朱优龙▲ 张敏康 夏红 |
| Department of Gastrointestinal Surgery,Xuzhou Central Hospital,Jiangsu Province,Xuzhou 221000,China |
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Abstract Objective To study the risk factors of anastomotic fistula after rectal cancer surgery.Methods The clinical data of 756 patients diagnosed with rectal cancer from January 2015 to December 2019 in the Gastrointestinal Surgery Department of Xuzhou Central Hospital were analyzed retrospectively.Among them,155 cases underwent abdominal perineal excision of rectal cancer (MILES surgery),39 cases underwent Hartmann surgery,and the remaining 562 cases underwent radical resection of rectal cancer (anterior resection of rectal cancer) were included in the study.Among them,there were 292 males and 270 females aged 35-91 years old,with a median age of 66 years old.Related risk factors included gender,age,intestinal obstruction,diabetes,preoperative hemoglobin level,preoperative albumin level,preoperative neoadjuvant chemotherapy,surgery time,distance from the tumor to the anal margin,laparoscopic surgery,intraoperative left colon vascular injury and intraoperative infusion of chemotherapy drugs.Results Altogether 39 of 562 surgical patients suffered from anastomotic fistula,with the incidence of 6.9%.The occurrence of anastomotic fistula after rectal cancer surgery was related to age,intestinal obstruction,preoperative albumin level,distance from the tumor to the anal margin and intraoperative left colon vascular injury (P＜0.05).The advanced age,intestinal obstruction,low preoperative albumin level and short distance from the tumor to the anal margin were independent risk factors for anastomotic fistula (P＜0.05).Conclusion The occurrence of anastomotic fistula in radical resection of rectal cancer is related to many factors such as age,intestinal obstruction,preoperative albumin level and distance from the tumor to the anal margin.
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