Risk factors of anastomotic leakage in the procedures of trans-abdominal and transanal total mesorectal excision for rectal cancer / 中华胃肠外科杂志

ABSTRACT

Anastomotic leakage is one of the most serious complications following traditional trans-abdominal total mesorectal excision of rectal cancer. Anastomotic leakage not only affects the postoperative recovery of patients, but also affects their long-term survival. Transanal total mesorectal excision (taTME) is a new surgical procedure developed in recent years. Its anastomosis is different from traditional trans-abdominal total mesorectal excision surgery. The risk of anastomotic leakage and related risk factors are also different. Anastomotic leakage of taTME has many risk factors, such as male gender, smoking, large tumor size, obesity, diabetes, methods of anastomosis, duration of surgery, and so on. Surgeons should analyze the risk of anastomotic leakage for every patient with rectal cancer based on patient characteristics, evidence-based medicine, and intraoperative status before deciding on whether diverting colostomy should be performed. In case of postoperative anastomotic leakage, surgeons should carefully select the best timing of performing diverting stoma to minimize the risks caused by the anastomotic leakage of the taTME procedure.