The Association between Slow Transit Constipation and Postoperative Anastomotic Leakage Patients withColorectal Carcinoma
YIN Wei,XU Jing,ZHAO Yong-jie
Department of General Surgery, Tianjin UnionCenter Hospital, Tianjin 300121, China
Abstract:
Objective The aim is to analyze the effect and the reason of slow transit constipation on postoperative anastomotic leakage of patients with colorectal carcinoma. Methods A retrospective analysis of 1128 colorectal carcinoma patients treated with operation in our general surgery department from October 1st, 2010 to October 1st, 2017. A total of 1307 patients were enrolled after exclusion. 1128 cases were in simple colorectal carcinoma patients group and 179 cases were in colorectal carcinoma patients group with slow transit constipation.Postoperative anastomotic leakage occurred in 109 patients, including 92 simple colorectal carcinoma patients and 17 colorectal carcinoma patients with slow transit constipation. The aim is to analyze the effect of slow transit constipation on the occurrence of postoperative anastomotic leakage by comparing the incidence, occurrence time and grade of anastomotic leakage between the two groups. The colorectal carcinoma patients with slow transit constipation were divided into two groups according to the presence or absence of ganglion cells in the proximal and/or distal colorectal wall of the anastomotic stoma, the incidence, occurrence time and grade of anastomotic leakage, which were also compared between the two groups to deeply explore the association between slow transit constipation and postoperative anastomotic leakage of patients with colorectal carcinoma on pathological level. Results The incidence of postoperative anastomotic leakage in colorectal carcinoma patients with slow transit constipation group was higher than that in simple colorectal carcinoma patients group (P < 0.05), and the occurrence time of anastomotic leakage was longer(P < 0.05) than the latter. Among 179 colorectal carcinoma patients with slow transit constipation,the incidence of postoperative anastomotic leakage in ganglion cell reduction or deletion of colorectal wall of the anastomotic stoma group was higher than that of normal group (P < 0.05), and the occurrence of anastomotic leakage was longer than that of normal group (P < 0.05). Conclusion Slow transit constipation increases the incidence of postoperative anastomotic leakage of patients with colorectal carcinoma and prolongs the occurrence time of anastomotic leakage. Higher incidence of postoperative anastomotic leakage in patients with slow transit constipation may be related to insuf?cient scope of colorectal resection, resulting in the decrease or absence of ganglion cells in the proximal and/or distal colorectal wall of the anastomotic stoma.
