[Reasons for anastomotic leakage following the learning curve by laparoscopic anterior resection of rectal cancer].

OBJECTIVE: To investigate the reasons of anastomotic leakage following learning curve by laparoscopic anterior resection of rectal cancer.
 Methods: From December, 2011 to March, 2015, the clinical information of 179 patients in our hospital who underwent dixon of rectal cancer were collected. The patients were divided into a laparoscopic learning group, a laparotomy group and a laparoscopic group. The reasons of anastomotic leakage for each group were comparatively analyzed. Repeated cutting of anastomotic stoma was compared between the laparoscopic learning group and the laparoscopic group. The male, age, obesity, nutrition complications and the position of anastomotic stoma were compared among the 3 groups.
 Results: The rate of anastomotic leakage in the laparoscopic learning group was significantly higher than that in the laparotomy group and the laparoscopic group (P<0.05). Repeated cutting was a significant risk factor in the laparoscopic learning group (P<0.05), but not in the laparoscopic group. Except obesity, the four factors were significant risk factors in the laparoscopic learning group (P<0.05). All of the five factors were not the significant risk factors in the laparotomy group and the laparoscopic group (P>0.05).
 Conclusion: The operation technical shortcoming is the major factor in the learning of the laparoscopic anterior resection of rectal cancer. In order to reduce the rate of anastomotic leakage in the learning curve period, the selection of patients following the laparoscopic anterior resection of rectal cancer should avoid the following factors: male, older age, the low position of the tumor and the nutrition complications.