A Study On The Clinicopathological Features And Postoperative Complications Of Rectal Cancer In Different Sites

ObjectiveTo compare the clinicopathological features and postoperative complications of high,middle and low rectal cancer,and to provide reference for the clinical diagnosis and treatment of rectal cancer.MethodsClinical and pathological data of 578 patients with rectal cancer who underwent surgical treatment in the first affiliated hospital of fujian medical university from January1,2014 to June 30,2019.06.30 were retrospectively collected.All patients were divided into three groups according to the location of the tumor in the rectum: 96 in the high group(high rectal cancer),203 in the middle group(middle rectal cancer),and 279 in the low group(low rectal cancer).Analysis of gender,age,BMI,preoperative albumin,preoperative hemoglobin,CEA and CA19-9,the operation time,postoperative hospitalization days,pTNM stage,lymph node inspection results,vascular invasion,nerve invasion,cancer nodules,maximum diameter,gross type of tumor,histological type,postoperative complications,such as 18 indexes,compare the clinical pathology characteristic and the postoperative complications between the three groups.Results(1)There was a difference in the average age of patients in the three groups(P <0.05).The lowest age in the low group was(59.8±11.3)years old,which was lower than that in the middle group(63.4±11.1)years old and the high group(62.8±9.4)years old.(2)There was no significant difference in the gross type,degree of differentiation,pTNM stage,vascular involvement,nerve invasion and cancer nodules of rectal cancer in different sites(P >,0.05).There was a significant difference in the positive rate of the circumferential margin in the three groups,and the positive rates of the high,middle and low groups were 3.1%,3.0% and 8.2%,respectively(P < 0.05).(3)The mean operation time of the lower group was the longest,which was(171.1±47.4)min,which was significantly higher than that of the middle group(138.9±44.4)min and the middle group(149.7±43.4)min,and the difference was statistically significant(P < 0.05).The average length of hospitalization after low post surgery was(15.1±6.7)days,which was significantly higher than that of the high post surgery group(13.5±5.9)days and the middle post surgery group(13.9±5.9)days,and the difference was statistically significant(P < 0.05).(4)The total incidence of postoperative anastomotic fistula in the whole group was7.4%,among which the incidence of anastomotic fistula in the low group was the highest(11.5%),which was significantly higher than that in the high group(4.2%)and the middle group(5.9%),and the difference was statistically significant(P < 0.05).Prophylactic fistula can significantly reduce the incidence of postoperative anastomotic fistula in the lower group(P < 0.05).In the middle and high rectal cancer,prophylactic fistula has no significant effect on the incidence of postoperative anastomotic fistula(P > 0.05).(5)The whole set of data of postoperative pulmonary infection,abdominal cavity infection,infection of incision,incidence of anastomotic bleeding were 10.2%,10.6%,9.9% and 2.6% respectively,between the three groups of postoperative incidence of pulmonary infection,abdominal cavity infection,infection of incision of the difference was statistically significant(P < 0.05),while the incidence of postoperative anastomotic bleeding,no obvious statistical significance(P > 0.05).ConclusionNo significant difference was found in the pathological stages of rectal cancer in different sites.There were significant differences in the incidence age,operative time and postoperative hospitalization days of rectal cancer in different sites.Compared with middle and high rectal cancer,the incidence of postoperative complications of low rectal cancer is higher,and prophylactic fistula can reduce the incidence of anastomotic fistula after low rectal cancer.