Anastomotic Fistula After Rectal Cancer Resection And Nutritional Risk Relationship Analysis

Objective:To explore the relationship between Preoperative nutritional risk(NRS2002) score and anastomotic leakage(AL) after rectal cancer resection.Methods:To collect 382 cases of anterior resection of rectal cancer were treated in the First Affiliated Hospital of Fujian Medical University from January 2009 to December 2015.Out of 6 cases of ineffective cases,According to the occurrence of anastomotic leakage is divided into two groups,Anastomotic leakage occurred in 21 cases of the experimental group, 361 cases of the control group did not occur.Respectively for age, gender, NRS2002 score, preoperative with hypertension, preoperative diabetes, anastomosis from the anal margin, preoperative on history of chemotherapy, surgery, intraoperative preventive colostomy, whether complicated with intestinal obstruction, TNM staging and other factors into statistical analysis.Identify risk factors on anastomotic fistula and analysis of preoperative nutritional risk(NRS2002) score and anastomotic leakage after anterior resection of rectal cancer.Statistical analysis using SPSS23.0 software,χ2 test was used for anastomotic fistula related risk factors were analyzed by univariate analysis,Multivariate analysis was performed using Logistic regression method.P < 0.05 difference was statistically significant.Results:A database of 382 patients with anterior resection for rectal cancer was extracted from the database, including 376 patients who received nutritional risk screening score.There were 21 cases of anastomotic leakage after operation, the proportion of which was 5.5%,175 cases of NRS2002 ≥3 patients, the proportion of which was 46.5%.Single factor analysis suggests NRS scores in the two groups, the anastomosis from the anal margin, tumor clinical pathological stage, differences in preoperative intestinal obstruction have statistical significance.Age, sex, preoperative combined with hypertension, preoperative and postoperative patients with diabetes, preoperative and postoperative radiotherapy and chemotherapy history,operation mode, whether there was no significant difference in the preventive stoma and other factors,After correct the factors as distance of anastomotic from the anal and tumor clinicopathological staging, multivariate analysis prompted that NRS2002 score ≥ 3 was a independent risk factor of anastomotic leakage following anterior resection for the rectal cancer(OR=3.175,95%CI 1.223-7.621)Conclusion:1:The preoperative nutritional risk is the independent risk factor of postoperative anastomotic leakage following anterior resection of rectal cancer.2:Nutritional risk screening(NRS2002 score)≥3 patients with preoperative nutritional risk, postoperative anastomotic fistula occurred with high probability.3.When NRS2002≥3, need to perioperative nutritional support, in order to reduce the incidence of postoperative anastomotic fistula.