On The Risk Factors Of Anastomotic Leakage After Colorectal Carcinoma Resection

Objective: To probe the possible factors of anastomotic leakage after colorectal carcinoma resection and offer preventional suggestions, and technical supports for its standardized treatments as well.Methods: Retrospectively analyze the factors of 70 anastomotic leakage cases found from 826 colorectal carcinoma resection cases with incidence being 8.5 per cent. All the cases are collected from the First Affiliated Hospital of Shi He Zi University and the Tumour Hospital of Hu Nan from Jan.1999 to Jan.2009.Results: There are 70 cases out of 826 had anastomotic leakage, with the incidence being 8.5 per cent. According to sex, we divide the collected cases into two groups: male and female; according to physical constitutions, divide into three groups:obesity, general, lankness; according to being complicated with diabetes or not, divide into diabetes group and non-diabetes group; according to operating surgeons, divide into chief surgeon group and associate chief surgeon group; according to using biological fibrin glue or not, divide into non-fibrin glue group and fibrin glue group; according to using surgical stapler or not, divide into non- surgical stapler group and surgical stapler group; according to smoking/drinking, divide into smoking/drinking group and non-smoking/drinking group; according to patients'ferrohemoglobin, divide into normal ferrohemoglobin group and low ferrohemoglobin group; according to the locations of tumors, divide into five groups:right hemi-colonic carcinoma, transverse colonic carcinoma, descent colonic carcinoma, sigmoid colonic carcinoma and rectal carcinoma; according to the Dukes stages of tumor, divide into four groups:A, B, C, D; according to the intestinal preparations, divide into well-prepared group and ill-prepared group; according to blood supplying situation of anastomosis, divide into normal blood supplying group and abnormal blood supplying group; according to the tensile force of anastomosis, divide into nonnal tensile force group and strong tensile force group; according to the level of serum albumin, normal group and low level group; according to ages, divide into two groups:<60,≥60; according to operation duration, divide into two groups:average duration and plus average duration, after X2 tests, P<0.05, indicating significant differences. Logistic regressive analysis on related risk factors of anastomotic leakage after colorectal carcinoma resection discovers that occurrence of anastomotic leakage is related with patient's sex, physical constitutions, being complicated with diabetes, using surgical stapler, smoking/drinking addiction, ferrohemoglobin, tumor locations, tumor stages, intestinal preparations, blood supplying situation of anastomosis, the tensile force of anastomosis, the level of serum albumin, age, operation duration, and is not related with operating surgeons, using biological fibrin glue.Conclusion: The occurrence of anastomotic leakage after colorectal carcinoma resection is related with several risk factors. Anastomotic leakage severely spoils patient's post-section life quality and even threatens his life. Understanding the risk factors of anastomotic leakage after colorectal carcinoma resection may help surgeon improve his operation, avoiding occurrence of anastomotic leakage, lessening patient's agony, improving patient's life quality and prognosis.