Why do patients with colon cancer develop anastomotic leakage after surgery

Anastomotic leakage is one of the serious complications after colon cancer surgery and is also an important cause of death in patients after colon cancer surgery. If not treated in time, the mortality rate is extremely high. So, why does anastomotic leakage occur in patients after colon cancer surgery?

① The patient's overall nutritional status is poor.

Colon cancer is common in the middle-aged and elderly, who often have chronic wasting diseases such as diabetes and liver cirrhosis, and the tumor itself causes excessive consumption of the patient. The combination of these factors leads to a serious decline in the patient's body's ability to repair and resist infection, which causes poor anastomotic healing.

②The intestines were not completely cleaned before surgery.

Most patients with left-sided colon cancer have varying degrees of obstruction, and preoperative intestinal preparation often fails to achieve the purpose of cleaning the intestine. When emergency surgery is required, it is difficult to completely decompress the intestine during surgery because of the high bacterial content of intestinal feces. If there is feces and gas accumulation in the intestinal cavity after surgery, it can lead to increased anastomotic tension, and at the same time, anastomotic contamination also increases the probability of anastomotic leakage.

③The blood supply to the intestinal anastomosis is poor.

Poor blood flow at the intestinal anastomosis, high tension at the anastomosis, or improper suturing can also cause anastomotic leakage. Good blood supply is an important factor in ensuring normal healing of the anastomosis. Excessive freeing of the mesentery of the intestinal stump or excessive removal of fat tissue around the colon anastomosis during surgery, damage to the colon mesenteric blood vessels, and insufficient or sparse suturing can all affect the healing of the anastomosis. When performing anastomosis on an intestinal tube that is congested, edematous, severely infected, or has residual tumors, the intestinal wall tissue generally does not heal well after surgery, and anastomotic leakage is prone to occur.