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| Effect of Prophylactic Ileostomy Distal Mucosal Closure on Anastomotic Fistula After Laparoscopic Radical Resection of Rectal Cancer and Its Related Factors |
| LIU Ruqian, SU Zhijian, LIN Zhou |
| The Affiliated Hospital of Jiangnan University, Jiangsu Wuxi 214000, China |
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Abstract Objective: To investigate the effect of prophylactic ileostomy distal mucosal closure on the occurrence of anastomotic fistula after laparoscopic radical resection of rectal cancer and its related factors. Methods: A retrospective analysis of the clinical data of 75 patients with rectal cancer admitted to our hospital from May 2019 to May 2020 was conducted. According to their surgical methods, they were divided into groups A (39 cases) and group B (36 cases). Group A was in laparoscopic rectal cancer. After radical cancer surgery, preventive ileostomy distal mucosal closure was performed. And group B received conventional laparoscopic radical rectal cancer surgery. The length of hospital stay, gastrointestinal function recovery time, anastomotic leakage healing time and postoperative occurrence were compared between the two groups, as well as the incision infection, intestinal adhesions and anastomotic leakage. According to whether an anastomotic leakage occurred after the operation, patients were subgrouped into anastomotic leakage group (10 cases) and non-anastomotic leakage group (65 cases). According to the results of univariate analysis, meaningful indicators were included into Logistic regression. Result: ① The postoperative hospital stay, gastrointestinal function recovery time and anastomotic fistula healing time in group A were lower than those in group B, P<0.05; ② The incidence of postoperative incision infection (5.13%), intestinal adhesion (7.69%) and anastomotic fistula (5.13%) in group A were significantly lower than those in group B (19.44%, 25.00%, 22.22%),P<0.05;③ Logistic regression showed that distance from tumor to anal margin was an independent risk factor for anastomotic fistula, P<0.05. Conclusion: Prophylaxis of distal mucosal closure of ileostomy after laparoscopic radical resection of rectal cancer has significant clinical effect on patients with rectal cancer, which can effectively reduce the probability of anastomotic fistula. The distance between tumor and anal margin is an independent risk factor for anastomotic fistula, which requires more clinical attention and targeted nursing care for patients.
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2021, Vol. 27 
