Beware of 2 complications after colon cancer surgery

Colon cancer is a common malignant tumor in the gastrointestinal tract. Thorough surgical resection after early diagnosis is the best treatment. There are many complications caused by surgical treatment of colon cancer, the most serious of which are anastomotic leakage and presacral bleeding.

1. Anastomotic leakage

Anastomotic leakage is a serious complication of colon surgery, with a higher incidence in left-sided colon and 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%.

The reasons are as follows:

Inadequate preoperative preparation;

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

The patient is malnourished;

Colorectal cancer patients are mostly middle-aged and elderly people, and cases are more common in the middle and late stages;

Surgical operation error.

Good blood supply is an important factor to ensure 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 supply to the anastomosis, excessive tension on the anastomosis, and insufficient suture, all of which can affect the healing of the anastomosis.

2. Presacral bleeding

Presacral bleeding is a serious complication of colon cancer surgery, and it is often fatal. The main reason is the damage to the presacral venous plexus when separating the posterior wall of the intestine. Since the presacral venous plexus is in a network shape, fixed in front of the sacrum, and communicates with the vertebral veins in the sacral foramen, it is difficult to stop bleeding once the bleeding point shrinks into the sacral foramen. In order to prevent the occurrence of presacral bleeding, the free posterior wall of the intestine should be carefully placed in the correct gap. The method of dealing with bleeding can be the nailing method. If it is really difficult to stop bleeding, gauze rolls can be used to compress and stop bleeding, and the effect is satisfactory. Do not suture blindly.