Prediction model for anastomotic leakage after laparoscopic rectal cancer resection

Shiwakoti, Enesh; Song, Jianning; Li, Jun; Wu, Shanshan; Zhang, Zhongtao

doi:10.1177/0300060520957547

Cited by 17 publications

(13 citation statements)

References 18 publications

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“…Some studies have found that BMI is a risk factor, even an independent risk factor, for AL in resection for colorectal cancer [25][26][27]. However, the other studies also have shown that BMI is not related to the possibility of AL in rectal cancer surgery [28].…”

Section: Discussionmentioning

confidence: 99%

Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study

Zheng

2021

Preprint

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Background：The impact of Hyperuricemia (HUA) on Dixon surgery is rarely reported. Anastomotic leakage (AL) is the main serious complication in Dixon surgery. We discussed the relationship between HUA and AL. Our aim was to identify these factors to provide intervention measures for clinical practice.Methods：The clinical data of 1147 patients who underwent Dixon operation for rectal cancer in the Second Affiliated Hospital of Fujian Medical University from January 2009 to December 2018 were retrospectively analyzed. Rank sum test was used for measurement data, and χ2 test was used for counting data. In univariate analysis, significant variables (P < 0.05) were used for multivariate analysis, and multivariable logistic regression was used to examine their independent roles. All tests were 2-sided, P<0.05 was considered statistically significant.Results：A total of 1147 patients with rectal cancer undergoing Dixon operation were included in the study, including 153 patients with HUA and 994 patients with normal uric acid (UA). The AL was 148 cases (14.9%) in UA group and 37 cases (24.2%) in HUA group. There was significant difference in AL (P = 0.006). The influence of HUA (P = 0.006), Tumor distance from the anal margin (TD) (P = 0.024) and preoperative chemoradiotherapy (PCT) (P = 0.040) on AL were significantly different. Logistic analysis showed that HUA (P = 0.021) and TD (P = 0.014) had significant effects on AL. In rectal cancer group with HUA, there were significant differences in the effects of male (P = 0.035), body mass index (BMI) (P = 0.017) and PCT (P = 0.013) on AL. Logistic analysis showed that there were significant differences between male (P = 0.001) and PCT (P = 0.004) on AL.Conclusions：HUA is an independent risk factor of AL in Dixon operation for rectal cancer. In patients with HUA undergoing Dixon operation, gender, BMI and PCT have significant difference on AL. Male and PCT are independent risk factors of AL.

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Section: Discussionmentioning

confidence: 99%

Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study

Zheng

2021

Preprint

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“…Compared with laparotomy, laparoscopic surgery shows promising efficacy and multiple benefits. 3 However anastomotic leakage (AL) has remains a devastating problem.…”

Section: Inductionmentioning

confidence: 99%

Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Anterior Resection of Rectal Cancer and Construction of a Nomogram Prediction Model

Wang¹,

Li²,

Li³

et al. 2022

CMAR

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Objective To explore the risk factors of anastomotic leakage (AL) after laparoscopic anterior resection (AR) of rectal cancer and establish a nomogram prediction model. Methods Clinical and surgical data of patients who underwent AR of rectal cancer at Sichuan Cancer Hospital from January 2017 to December 2020 were retrospectively collected. Univariate and multivariate logistic regression analyses were used to screen the independent risk factors of AL after AR. A nomogram risk prediction model was established based on the selected independent risk factors and the predictive performance of nomogram was evaluated. Results A 1013 patients undergoing laparoscopic AR were included, of which 67 had AL, with an incidence of 6.6%. Univariate and multivariate logistic regression analyses showed that male gender, tumors distance from the anus verge of ≤ 5cm, tumors distance from the anus verge of 5–10cm, circumferential tumor growth, operation time ≥ 240min, and no diverting stoma were independent risk factors for AL after AR. A nomogram prediction model was established based on these results. The calibration curve showed that the predicted occurrence probability of the nomogram model was in good agreement with the actual occurrence probability. The area under the receiver operating characteristic (ROC) curve was 0.749. Conclusion The nomogram prediction model based on the independent risk factors of patients undergoing AL after AR can effectively predict the probability of AL.

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“…Laparoscopic surgery for rectal cancer is safe and feasible, 1,2 and it has become the preferred technique over open surgery. 3 An excellent surgical field is provided in a narrow pelvis by laparoscopic surgery during rectal resection.…”

Section: Introductionmentioning

confidence: 99%

“…Pelvic drainage serves as an indicator of anastomosis that reflects its integrity. 13 According to the experiences of different surgeons, clinical AL was indicated by the presence of clinical signs such as abnormal discharge from the pelvic drain tube (gas, pus, or feces), 3,4,14 peritonitis, 2,3,13 postoperative fever, 3,4 postoperative leukocytosis, 4 postoperative abdominal pain, 3 rectovaginal fistula, 4 or pelvic abscess. 4 If leakage is suspected, then abdominopelvic computed tomography (CT), 3,4,14 sigmoidoscopy, 4,14 rectal examination 4,14 or water-soluble contrast enema 4 should be conducted to confirm the diagnosis of AL.…”

Section: Introductionmentioning

confidence: 99%

Drainage smell and peritonitis are efficient indicators of anastomotic leakage after laparoscopic rectal cancer resection

Shiwakoti

Song

et al. 2020

J Int Med Res

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Objective Anastomotic leakage (AL) is a frequent complication after laparoscopic rectal cancer resection (LRCR). The main objective of the present study was to identify accurate indicators of AL after LRCR. Methods A retrospective case-control study was performed of 185 patients who underwent laparoscopic surgery for rectal cancer between March 2012 and February 2017 at Beijing Friendship Hospital. Potential indicators of AL were examined via univariate and multivariate analyses. The performance of multivariate analysis was evaluated using receiver operating characteristic (ROC) curves. Results The overall AL rate was 17.84%. Multivariate analysis identified drainage smell (odds ratio [OR = 35.318, 95% confidence interval [CI] = 7.114 to 175.338) and peritonitis [OR = 17.475, 95% CI = 1.540 to 198.318) as independent indicators of AL. The area under the ROC curve was 0.720 (95% CI = 0.606 to 0.835). Conclusion Drainage smell and peritonitis could be reliable and accurate indicators of AL after LRCR.

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Prediction model for anastomotic leakage after laparoscopic rectal cancer resection

Cited by 17 publications

References 18 publications

Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study

Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study

Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Anterior Resection of Rectal Cancer and Construction of a Nomogram Prediction Model

Drainage smell and peritonitis are efficient indicators of anastomotic leakage after laparoscopic rectal cancer resection

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