considerable extra cost, increased in-hospital morbidity and mortality, impaired pelvic organ function (Eriksen et al., 2005; Law et al., 2007; Lee et al., 2008;Riss et al., 2011). Although there are multiple risk factors, such as being male, advanced age, severe obesity, lower tumor site (less than 4cm from the anal verge) and the reduction of TSGF in POD5, which are associated with anastomotic leakage have been reported in our previous study (Yang in individual patients on account of the absence of a early stage.The diagnosis of AL should be as early as possible for the sake of reducing its associated morbidity and mortality (Doeksen et al., 2007). Many studies on anterior resections regarding AL come from multi-center and different surgeons. A variety of factors predisposing to AL have been reported in the previous investigations. However, lack of data about the risk factors and incidence associated with AL from a single-institute of one team of doctors.
Liu Yang et al
5442In addition, a great deal previous studies are repetitive works and duplicated effforts because of the limited power of innovative thinking. The pathophysiological processes and considering that interstitial acidic pH notion that extracellular acidosis may intensify the acute and extending its functional lifespan (Trevani et al., 1999; Martínez et al., 2006). The acidic microenvironments developing and the pelvic draining is becoming acidic, which is the main theoretical foundation for the present research. This study aimed to evaluate the utility of sequential postoperative pelvic drainage determinations of of AL after anterior resection of rectal cancer, which has not been reported ever before.
Materials and MethodsBetween January 2004 and December 2011, 753 consecutive patients with rectal cancer underwent anterior resection with double stapling anastomosis for primary Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research, Nanjing, China. The medical notes of all patients were reviewed in detail.of TNM stage, histologically proven adenocarcinoma, open and laparoscopic surgery with pelvic drainage, all patients with 12 postoperative determinations of pH value, and antibiotics using for 7 PODs. Exclusion criteria were of TNM stage, colon cancer, hand-sewn anastomosis and perioperatively abdominopelvic implants that might be affect pH value, ongoing infection before surgery or an acquired infection in the postoperative period other the distance from the anal verge, as determined by rigid sigmoidoscopy. Total mesorectal excision was adopted as the standard surgical technique according to tumor location. The Ethics Committee of Science approved data collection in the register.All the patients were assigned to one of two groups according to the presence or absence of AL: with AL (Group AL, n=57), without AL (Group nAL, n=696). The two groups were compared according to the following characteristics: median age, gender, physical status (ASA score), the alcohol and tobacco abuse, tumor site, TNM stage, pre...