Analysis And Prevention Of Early Complications After Laparoscopic-Assisted Radical Resection Of Colorectal Cancer

Objective:To explore the risk factors associated with recent complications after laparoscopic-assisted radical colorectal cancer surgery,take necessary precautions to avoid risk before surgery,and respond quickly to the complications that have occurred after surgery and implement effective treatment programs.Finally,the clinical decision-making basis was summarized for the prevention,diagnosis and treatment of short-term complications after laparoscopic assisted radical resection of colorectal cancer.Postoperative complications were graded using the Clavine-Dindo criteria.One-way chi-square test was performed on each complication using SPSS 21.0 statistical software to screen out the risk factors for postoperative complications.Methods:The clinical data of 510 patients who underwent laparoscopic assisted radical surgery of colorectal cancer in the Department of Gastrointestinal Surgery,Zhongshan Hospital,Xiamen University from January 2015 to January 2019 were collected.There were 303 males and 207 females,the oldest was 88 years old,the youngest was 23 years old,and the average age was(61.0±12.2)years old.Results:In this study,510 patients had a total of 149 cases of postoperative complications of grade II and above in Clavine-Dindo.Among them,25 cases(4.90%)had postoperative anastomotic leakage,14 cases(2.75%)had postoperative hemorrhage,17 cases(3.33%)had intestinal obstruction,4 cases(0.78%)had chyle leakage,and 24 cases(4.71%)had surgical site infection.There were 46 cases(9.02%)with pulmonary infection,18 cases(3.53%)with urinary retention,and 1 case(0.19%)with postoperative gastroparesis syndrome.The chi-square test results showed:correlation between hypoalbuminemia(p=0.004),preoperative obstructive symptoms(p=0.017)and postoperative anastomotic leakage;correlation between obstructive symptoms(p=0.046)and postoperative bleeding;correlation between hypoalbuminemia(p=0.003),preoperative diabetes(p=0.015),preoperative anemia(p=0.006)and surgical site infection;correlation between age(p=0.002),operation time(p=0.015)and postoperative pulmonary infection;correlation between gender(p=0.035),age(p=0.008)and postoperative urinary retention(p<0.05).Conclusion:Hypoalbuminemia and preoperative obstruction are risk factors for postoperative anastomotic fistula.Preoperative obstruction is a risk factor for postoperative bleeding.Hypoalbuminemia,preoperative diabetes mellitus and preoperative anemia are risk factors for surgical site infection.Advanced age and long operation time are the risk factors for postoperative pulmonary infection.Gender(male)and advanced age are risk factors for postoperative urinary retention.The experience and lessons have been summarized to provide the basis for clinical decision-making for the prevention,diagnosis and treatment of the short-term complications after laparoscopic-assisted radical resection of colorectal cancer.