Analysis of Incidence and Influencing Factors of Early Anastomotic Leakage after Laparoscopic Low Anterior Resection of Rectum
Objective:To investigate the incidence and influencing factors of early anastomotic leakage(AL)after laparoscopic low anterior resection(LAR)of rectum.Method:The clinical data of 344 patients with rectal cancer who underwent laparoscopic LAR in the First Affiliated Hospital of Soochow University from January 2020 to June 2021 were retrospectively analyzed,the patients were divided into no AL group and AL group according to the early postoperative anastomotic healing.Age,gender,American Society of Anesthesiologists(ASA)classification,past medical history(hypertension,diabetes,anemia,hypoproteinemia,hyperlipidemia),degree of abdominal aortic calcification,preservation of left colonic artery,tumor location,preventive stoma,T stage and N stage of all patients were collected,univariate and multivariate analysis were used to explore the influencing factors of early postoperative AL.Result:Among 344 patients with laparoscopic LAR,55 cases(15.99%)developed early postoperative AL.There were no significant differences in the gender,ASA grade,hypertension,hyperlipidemia,operation time,T stage and N stage between two groups(P＞0.05);there were significant differences in the age,diabetes,anemia,hypoproteinemia,high degree of abdominal aortic calcification,preservation of left colonic artery,tumor site and preventive stoma between two groups(P＜0.05).Multivariate logistic regression analysis showed that the independent risk factors for early AL after laparoscopic LAR were age,diabetes,hypoproteinemia,high degree of abdominal aortic calcification,and low rectal tumor,the protective factors for early AL after laparoscopic LAR were preservation of left colonic artery and prophylactic ileostomy(P＜0.05).Conclusion:For patients with risk factors such as advanced age,diabetes,hypoalbuminemia,low rectal tumor,and high abdominal aortic calcification,the risk of early AL after laparoscopic LAR will increase,and the incidence of early AL after prophylactic ileostomy and preservation of left colonic artery will decrease.
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