Determining the protective characteristics and risk factors for the development of anastomotic leakage after low anterior resection for rectal cancer

Abstract

Purpose Anastomotic leakage is one of the most serious postoperative complications associated with surgery for rectal cancer. The present study aimed to identify the protective characteristics and risk factors associated with anastomotic leakage after low anterior resection for rectal cancer. Methods This was a retrospective, single-center study conducted between January 2009 and December 2017 at our institution. In total, 136 rectal cancer patients who underwent low anterior resection were included in the study. We analyzed preoperative and intraoperative factors. In addition, the pelvic dimensions were measured using computed tomography in all cases. Results Among the 136 patients, anastomotic leakage occurred in 21 (15.4%), including 18 males and 3 females. The median body mass index was 21.1 kg/m2. The construction of a covering stoma was found to be a protective factor. In addition, the operation time (≥ 373 min), intraoperative blood loss (≥ 105 ml), and size of the pelvic inlet (≥ 113 mm) were identified as risk factors for anastomotic leakage. Conclusion The construction of a covering stoma was a possible protective factor. However, a longer operation time, higher intraoperative blood loss, and larger pelvic inlet dimensions were possible risk factors for developing anastomotic leakage after low anterior resection in patients with rectal cancer.

The risk factors of low anterior resection syndrome after colorectal cancer surgery: A retrospective study of 566 patients in a single institution in China

“…In 2021, Suzuki, N et al, ( 48 ) also reported anastomotic complications, such as leakage, which was confirmed to be associated with a 3.5-fold increase in the incidences of major LARS. However, we could not find anastomotic complications increasing the incidences of major LARS in our study, and we thought this was due to the development of operation skills and reliable management of patients after operation in recent years.…”

The Risk Factors of Low Anterior Resection Syndrome After Colorectal Cancer Surgery Compared with the Last Decade Studies

“…In 2021, Suzuki, N et al, [49] also reported anastomotic complications, such as leakage, which was con rmed to be associated with a 3.5-fold increase in the incidences of major LARS. However, we could not nd anastomotic complications increasing the incidences of major LARS in our study, and we thought this was due to the development of operation skills and reliable management of patients after operation in recent years.…”

Systematic review of the significance of neutrophil to lymphocyte ratio in anastomotic leak after gastrointestinal surgeries

“…We found no further relevant studies in grey literature and handsearching. After excluding irrelevant studies and duplicates, we included 12 studies in the present systematic review and meta-analysis for a total of 2940 patients undergoing GI surgeries, of whom 353 developed AL [4,[15][16][17][18][19][20][21][22][23][24][25]. The PRISMA flow diagram in Fig.…”

“…In terms of study design, there were two prospective and 10 retrospective studies. Studies were conducted in China(n = 3) [17,18,25], Italy (n = 2) [19,22], Romania(n = 2) [4,20], Japan(n = 2) [23,24], Indonesia(n = 1) [15], Turkey(n = 1) [16], and Mexico(n = 1) [21]. So, there were six studies on white people, with 2106 patients, of whom 200 developed AL [4,16,[19][20][21][22], and six studies on East Asian people, with 834 patients, of whom 153 developed AL [15,17,18,[23][24][25].…”

“…Studies were conducted in China(n = 3) [17,18,25], Italy (n = 2) [19,22], Romania(n = 2) [4,20], Japan(n = 2) [23,24], Indonesia(n = 1) [15], Turkey(n = 1) [16], and Mexico(n = 1) [21]. So, there were six studies on white people, with 2106 patients, of whom 200 developed AL [4,16,[19][20][21][22], and six studies on East Asian people, with 834 patients, of whom 153 developed AL [15,17,18,[23][24][25]. Four studies, with 513 patients, of whom 67 developed AL, included patients undergoing gastric surgery [4,16,21,22], four studies, with 1783 patients, of whom 168 developed AL, included patients undergoing colorectal surgery [15,19,21,24], and four studies, including 644 patients, of whom 118 developed AL, were on esophageal surgery [17,18,23,25].…”