Abstract:Objective To investigate the risk factors for anastomotic leakage in patients who have undergone laparoscopic radical resection for rectal cancer. Methods The clinical data of 146 patients treated at the First Hospital of Shanxi Medical University between June 2014 and June 2018 was retrospectively analyzed. Results Surgery was successful in all cases without conversions to open operation. The overall anastomotic leakage rate was 8.90%(13 of 146) and 10 cases were observed in males and 3 cases in females only. The occurrence of anastomotic leakage was related to the preoperative albumin level, the distance between the lower edge of the tumor and the anus, and the number of linear staplers used during the operation. The incidence of anastomotic leakage was higher in patients with preoperative albumin levels lower than 35 g/L, the distance between the lower edge of the tumor and the anus shorter than 7 cm, and the number of linear staplers used intraoperatively (P=0.013,P=0.037,P=0.011). Multivariate analysis showed that preoperative albumin levels (OR=4.092, 95% CI: 1.231-13.602) and intraoperative use of occluders (OR=4.272, 95% CI: 1.285-14.202) were independent risk factors for anastomotic leakage. Conclusions Low preoperative albumin levels(<35 g/L), the number of linear staplers used during operation, and the distance between the lower edge of the tumor and the anus less than 7 cm are risk factors for anastomotic leakage after laparoscopic radical resection for rectal cancer. Surgeons should pay more attention to patients with one or more of these indications, and necessary preventive measures should be taken.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018,10:1-31.
[2]
Kanellos D, Pramateftakis M G, Vrakas G, et al. Anastomotic leakage following low anterior resection for rectal cancer[J]. Tech Coloproctol, 2010, 14(1):35-37.