Three reasons for anastomotic leakage after colon cancer surgery

Anastomotic leakage is a serious complication after colon cancer surgery, and the incidence is higher after left-sided colon surgery. The incidence of anastomotic leakage with traditional manual operation is 5% to 10%. The incidence of anastomotic leakage has decreased after the use of stapler technology, which is about 2.5% to 6.6%.

There are three reasons for anastomotic leakage after colon cancer surgery:

1. Inadequate preoperative preparation

Domestic literature reports that the incidence of complications in colon cancer surgery under emergency conditions is as high as 74.1%.

2. Patients are malnourished

Most colorectal cancer patients are middle-aged and elderly people, and middle- and late-stage cases are more common.

3. Surgical operation errors

Good blood circulation is an important factor in ensuring the normal healing of the anastomosis. Excessive freeing of the mesentery of the intestinal stump or excessive removal of the fat tissue around the colon anastomosis during the operation will damage the colon mesenteric blood vessels, resulting in poor blood circulation at the anastomosis, excessive tension on the anastomosis, and insufficient suture, all of which can affect the healing of the anastomosis.

To prevent anastomotic leakage after colon cancer surgery, three points should be achieved:

1. Strictly master the indications for primary colorectal surgery, especially in cases of acute intestinal obstruction;

2. During the operation, pay attention to the blood circulation and tension of the anastomosis. During the operation, the intestinal cavity should be clean and the anastomosis should meet the conditions of being empty above, straight and unobstructed below;

3. Once anastomotic leakage is diagnosed, enterostomy or Hartmann's procedure should be performed actively, and effective drainage, surgical nutrition and anti-infection treatment should be given at the same time.