Prevention And Management Of Stoma Leak After Anterior Resection Of Rectal Cancer

Background:Stoma leaks are widely held as one of the most important and morbid postoperative complications of rectal surgery. The study of stoma leaks has had a long and thorough history with recent landmark papers proving the safety of stapled techniques. Despite this extensive study, leaks continue to occur with significant morbidity and mortality rates. For example, recent reports have confirmed that rectal cancer local recurrence rates and cancer-related mortality are increased by the occurrence of an stoma leaks. Although most literature assesses stoma leak risk factors for specific patient populations and procedures, fewer reports assess stoma leak management. This study was designed to investigate the contemporary management of the anastomotic leak patient.Objective To approach the prevention and the management to the complication of stoma leak of 180 patients with rectal cancer after Anterior Resection (AR). Methods the clinic date of 180 patients with rectal cancer who were performed from November 2009to November 2010 in department of common surgery of xinhuat hospital affiliated to dalian University was analyzed. Results After AR,12 of 180 patients (6.67%,12/180) suffered from stoma leak and 7 patients (58.3%,7/12) were cured by expectant treatment while 2 patients (16.7%,2/12) were cured by reoperation. In analysis, the following parameters were associated with an increased risk for stoma leak:BMI,ASA score,operative time,diabetes mellitus,disease location,cleaness of intestine.Conclusion The superiority of AR and TME was accepted extensively, but the risk factors should be considered in perioperative decision-making.