Rò miệng nối sau phẫu thuật nội soi cắt toàn bộ mạc treo trực tràng

Abstract

Objective: To experience and some factors related to anastomotic leak in rectal cancer surgery. Subject and method: This was a retrospective study. A total of 120 patients with rectal cancer have undergone laparoscopic total mesorectal excision at 108 Military Central Hospital from January 2019 to November 2020. Result: 65.0% patients with laparoscopic total mesorectal excision and 35.0% with intersphincteric resection. The average age was 62.9 (range 20 - 84), rectal tumor location: The upper third, middle third, and lower third was 27.5%, 48.3%, and 24.2%, respectively. The rate of anastomotic leak was 8.3% patients, in which grade A, B, and C was 1.7%, 0.8%, and 5.8%, respectively. Anastomotic leak that required re-operation was 5.8%. Anastomotic leak was significantly associated with intraoperative loss blood (p=0.022), operative time (p=0.03), the distance of anastomosis from the anal verge (p=0.042), and surgical procedure (p=0.015). Anastomotic leak was not significantly associated with preoperative factor such as: Age, sex, tumor length, tumor invasion, lymph node metastases, combined disease, and preoperative chemoradiotherapy (p>0.05) as well as an intraoperative factor: Anastomotic technique, stoma diverting ileostomy, and anal drainage tube (p>0.05). Conclusion: In this study, intraoperative loss blood, operative time, the distance of anastomosis from the anal verge, and surgical procedure (to were associated with anastomotic leak in rectal surgery. Early detection and classification of anastomotic leak play an important role in the treatment of colorectal anastomotic leaks.