Risk Factors for Postoperative Anastomotic Leakage Complicated with Ab-dominal Infection in Patients with Colon Cancer

WEN Jiazhi; XIANG Rong

doi:10.3969/j.issn.1002-3429.2024.14.013

Abstract：Objective To investigate the risk factors for postoperative anastomotic leakage complicated with abdomi-nal infection in patients with colon cancer.Methods From March 2019 to January 2022,91 patients with anastomotic leak-age after radical resection of colon cancer were selected and divided into two groups according to whether they were complicated with abdominal infection after operation.Forty patients in the research group were those with anastomotic leakage after radical resection of colon cancer complicated with abdominal infection,and 51 patients in the control group were those with anastomot-ic leakage after radical resection of colon cancer without abdominal infection.The distribution characteristics of pathogens in the research group,and the levels of procalcitonin and C reactive protein(CRP)on the third day after operation in the two groups were analyzed,and the risk factors of anastomotic leakage complicated with abdominal infection after radical resection of colon cancer were explored by binary logistic regression.Results A total of 50 strains of pathogenic bacteria were detected in patients with anastomotic leakage complicated with abdominal infection after radical resection of colon cancer,including 33 strains of Gram-negative bacteria,in which there were 12 strains of Escherichia coli(24.0%),9 strains of Klebsiella(18.0%),7 strains of Pseudomonas aeruginosa(14.0%),3 strains of Acinetobacter baumannii(6.0%)and 2 strains of Enterobacter cloacae(4.0%),12 strains of Gram-positive bacteria,in which there were 7 strains of Staphylococcus epidermi-dis(14.0%),3 strains of Staphylococcus aureus(6.0%),1 strain of Streptococcus pneumoniae(2.0%),1 strain of En-terococcus faecalis(2.0%),and 5 strains of fungi.The levels of procalcitonin and CRP in the research group were signifi-cantly higher than those in the control group at 3 d after operation(P＜0.05).Binary logistic regression analysis showed that combined diabetes mellitus,CRP and procalcitonin were the risk factors of postoperative anastomotic leakage complicated with abdominal infection in patients with colon cancer,while albumin was the protective factor(P＜0.05).Conclusion Gram-negative bacterial infection is the main risk factor for postoperative anastomotic leakage complicated with abdominal infection in patients after radical resection of colon cancer.Combined diabetes,CRP and procalcitonin are considered to be risk factors for postoperative anastomotic leakage complicated with abdominal infection in patients with coloncancer,while albumin is the pro-tective factor.