Risk factors of anastomotic stricture after laparoscopic low anterior resection in the middle and low rectal cancer
Objective To investigate risk factors of anastomotic stricture after laparoscopic low anterior resection(LAR)in the middle and low rectal cancer.Methods Totally 825 patients with rectal cancer who underwent laparoscopic sur-gery admitted to the First Affiliated Hospital of Zhengzhou University from April 2017 to December 2020 were retrospec-tively analyzed,univariate analysis and logistic multivariate regression analysis were used to investigate the risk factors for anastomotic stricture.Results Among the 825 patients,71(8.6％)were diagnosed as having anastomotic stric-ture.Univariate analysis revealed that preoperative radiotherapy,no preservation of left colic artery,prophylactic termi-nal ileostomy,and intersphincteric resection(ISR)with hand-sewn anastomosis were risk factors of anastomotic stric-ture(P＜0.01).Multivariable logistic regression analysis revealed that preoperative radiotherapy,no preservation of left colic artery and ISR with hand-sewn anastomosis were independent risk factors of anastomotic stricture(P＜0.01).Univariate analysis revealed that preoperative radiotherapy tended to be associated with permanent stoma,but have no statistically significant association(P=0.069).Conclusion Preoperative radiotherapy,no preservation of left colic ar-tery and ISR with a hand-sewn coloanal anastomosis were independent risk factors of anastomotic stricture after laparo-scopic surgery for low-lying rectal cancer.Surgeons should be alert to the risk of anastomotic stricture and permanent enterostomy after preoperative radiotherapy.
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