Prevention of Anastomotic Fistula Formation after Low-position DIXON OPERATION Beginning with Operative Procedure Details

Objective: This study aimed to investigate the main points of preventing anastomotic fistula formation after low-position Dixon operation.

Methods: From September 2004 to October 2007, our department continuously conducted 146 cases of low-position Dixon operations. The operation mode involved transabdominal radical resection based on total mesorectal excision for all cases. Except for tumor infiltration, one side of the pelvic vegetative nerve was maintained and ligations were conducted at the superior rectal artery root. Mesorectum at the anastomosis site was removed up to the tunica muscularis recti. The anastomotic stoma blood supply was good and had no tension. An anal tube was inserted when the anastomotic stoma was within 3 cm away from the anal margin. For all cases, a presacral drainage tube was placed via the perineal position.

Results: For all 146 cases, no anastomotic leakage occurred and the post-operative complications included two cases of anastomotic bleeding, three cases of anastomotic stenoses, 48 cases of increased defecation (4-6 times of defecation daily), 34 cases of anal irritation symptoms, and 6 cases of poor loose stool control capacities.

Conclusion: Ensuring enough blood supply for the anastomotic bowel on the two sides, eliminating tension and accurate anastomosis at the anastomosis site could be effective measures to prevent anastomotic fistula in the low position anus preserving surgery of colorectal cancer.