Causes of anastomotic leakage after rectal cancer surgery

Anastomotic leakage is the most common and most serious complication after rectal cancer surgery. The main factors causing this complication are:

1. Systemic factors

These include patients who are old, weak, malnourished, have underlying diseases such as hypoproteinemia, diabetes, blood diseases, and long-term use of hormones. These patients have poor tissue repair ability and are prone to anastomotic fistula after surgery.

2. Excessive tension at the anastomosis

It is mainly due to low-position anastomosis or obesity of the patient, which causes excessive tension at the anastomosis, spasm or tearing of blood vessels, and ischemic necrosis of tissues around the anastomosis.

3. Patients with chronic intestinal obstruction

Patients with intestinal obstruction are often accompanied by malnutrition, severe intestinal edema, and significant dilatation of the proximal intestinal tract, which makes the intestinal tract calibers at both ends of the anastomosis asymmetrical and cannot be reliably anastomosed. In addition, the presence of intestinal obstruction also increases the possibility of anastomotic infection;

4. Gender

The incidence of anastomotic leakage in male patients is higher than that in female patients, which may be related to the narrow pelvis and relatively deep pelvic cavity in men, making it difficult to obtain the best surgical field;

5. Distance between the tumor and the anus

The lower the tumor is located, the more difficult the surgery is and the greater the chance of anastomotic leakage.