Analysis in influencing factors of endoscopic treatment for anastomotic leakage after radical resection of colorectal carcinoma

Objective To investigate the influencing factors of endoscopic treatment for anastomotic leakage after radical resection of colorectal cancer.

Methods Clinical materials of 71 patients with endoscope-assisted anastomotic leakage after radical resection of colorectal cancer from January 2015 to December 2020 were retrospectively analyzed, including gender, age, preoperative hemoglobin level, glycosylated hemoglobin, serum albumin level, tumor location, tumor staging, history of neoadjuvant chemotherapy, occurrence time of anastomotic leakage, duration of endoscopic treatment, size of leakage, endoscopic treatment methods, remission of postoperative symptoms, volume of drainage fluid and hospitalization. According to the therapeutic effect, the patients were divided into complete remission group and partial remission group, and the differences of various indexes were compared between the two groups.

Results Among 71 patients, anastomotic leakage in 42 cases were completely relieved after endoscopic treatment, and the effective rate was 59.15%; anastomotic leakage in 29 cases were not completely closed after endoscopic treatment; the average drainage volume of patients with effective outcome for anastomotic leakage at 3 days after treatment was significantly less than that of patients with incomplete closure of anastomotic leakage (P < 0.01). There were significant differences in glycosylated hemoglobin level, size of leakage and the time from the diagnosis of anastomotic leakage to endoscopic treatment between the complete remission group and the partial remission group (P < 0.05 or P < 0.01). The multivariate analysis showed that the time from the diagnosis of anastomotic leakage to endoscopic treatment, the size of the leakage and the level of glycosylated hemoglobin were the independent factors affecting the curative effect (P < 0.05 or P < 0.01).

Conclusion The time from the diagnosis of anastomotic leakage to endoscopic treatment, the size of the leakage and the level of glycosylated hemoglobin are the independent influencing factors for efficacy of endoscope-assisted treatment for anastomotic leakage after radical resection of colorectal cancer. When the anastomotic leakage of colorectal cancer occurs, the blood glucose and glycosylated hemoglobin levels should be actively controlled, early endoscopic treatment should be performed, and appropriate methods should be selected according to the size of the leakage in order to achieve maximal clinical benefits for the patients.