Analysis On Risk Factors Of Anastomotic Fistula After Laparoscopic Rectal Cancer Dixon Surgery And Preventive Measures

Objective:To investigate the risk factors of anastomotic leakage after laparoscopic rectal cancer Dixon surgery,to analyze the methods of diagnosis and treatment, and to summarize preventive measures to reduce the occurrence of postoperative anastomotic fistula.Methods:Clinical data of 265 patients undergoing laparoscopic rectal cancer Dixon surgery in Department of General Surgery and Department of Colorectal and Anal Surgery, the First Affiliated Hospital of Guangxi Medical University, from May 2014 to November 2015 were retrospectively analyzed, including 143 cases of male and 122 cases of female. These patients aged between 24 and 93, with the average age of 60.Univariate chi-square test and multivariate logistic regression analysis were performed to select independent risk factors of postoperative anastomotic fistula by SPSS 16.0 statistical software.Results:In 265 cases,13 patients had clinically evident anastomotic fistula after undergoing laparoscopic rectal cancer Dixon surgery (4.9%,13/265).Univariate chi-square test show that gender, serum albumin level before surgery, size of tumor, operation time and the distance from stoma to anal edge were associated factor, and X-squared value were 0.004,0.007,0.022,0.005 and 0.015, respectively, P< 0.05. Multivariate logistic regression analysis show that gender, serum albumin before surgery and distance from stoma to anal edge were the risk factors of anastomotic fistula after postoperation and relative risks (RRs)were 1.146、1.258、1.548, respectively, P< 0.05.Conclusions:Gender, serum albumin before surgery, size of tumor, operation time, the distance from stoma to anal edge are associated with the occurrence of postoperative anastomotic fistula. Gender (male), serum albumin level<30g/L before surgery and the location of stoma (a distance from stoma to anal edge< 5 cm), are independent risk factors of postoperative anastomotic fistula.The experience gained from clinic work are the important measures of prevent anastomotic fistula after undergoing laparoscopic rectal cancer Dixon surgery.