Abstract:

Objective To explore the clinical effects of laparoscopic free pedicled omentum in covering high⁃risk anastomotic stoma after colorectal cancer surgery. Methods A retrospective analysis of clinical data of 239 patients with high⁃risk anastomotic fistula who underwent laparoscopic colorectal cancer resection at the General Surgery Department of Zhengzhou University Cancer Hospital from January 2014 to June 2019. According to the condition that whether the omentum covered the anastomosis during the operation，they were divided into an experi⁃ mental group（115 cases）and a control group（124 cases）. The intraoperative bleeding volume，operation time， incision length，postoperative hospital stay，rate of anastomotic leakage and outcome were compared between the two groups. Results （1）In the experimental group，3 cases had anastomotic fistulas，and the rate of anastomotic leakage was 2.6%. In the control group，11 cases had anastomotic fistula，and the rate of anastomotic leakage was 8.9%. There was a statistical difference between the two groups（P < 0.05）. The intraoperative bleeding volume， operation time，incision length，and postoperative hospital stay were no statistical difference between the two groups（P > 0.05）.（2）Three cases with anastomotic leakage in the experimental group improved after active con⁃ servative treatment. In the control group，3 patients improved after active conservative treatment，7 patients were cured by secondary surgery，and 1 patient died. Conclusion For colorectal cancer patients with high⁃risk factors， laparoscopic free pedicled omentum wrapped anastomotic stoma can effectively reduce the occurrence of anastomotic leakage. It is a safe and effective prevention method.

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