Prediction model of anastomotic leakage after anterior resection for rectal cancer—based on nomogram and multivariate analysis with 1995 patients

Li, Ruiqi; Zhou, Jiajie; Zhao, Shuai; Sun, Qiannan; Wang, Daorong

doi:10.1007/s00384-023-04438-1

Cited by 7 publications

(3 citation statements)

References 73 publications

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“…In the literature, the incidence rate of an anastomotic leak ranges between 1-21% [1][2][3][4][5][6]. In a large systematic review of 71 studies and 24,288 rectal cancer patients treated by anterior resection, the reported pooled overall median rate of anastomotic leakage was 8.58% (range: 1.22-20.50%) [1].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a nomogram for the prediction of anastomotic leakage after anterior resection was created based on a multivariate analysis of 1995 patients. A nomogram was created with several factors related to anastomotic leakage, such as male sex, diabetes, neoadjuvant therapy, tumour distance from the anus verge < 5 cm, tumour size ≥ 5 cm, and blood loss > 50 mL, but this model still requires validation by prospective studies [3].…”

Section: Discussionmentioning

confidence: 99%

“…The creation of a colorectal or coloanal anastomosis represents a critical step during anterior resection due to the risk of postoperative anastomotic leakage. In the literature, the incidence of anastomotic leakage is extremely variable and ranges between 1% and 21% [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Role and Morbidity of Protective Ileostomy after Anterior Resection for Rectal Cancer: One Centre Experience and Review of Literature

Coco,

Tondolo,

Amodio

et al. 2023

JCM

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The creation of a protective stoma is considered a valid life-saving tool, significantly reducing the effects of anastomotic leakage in terms of related morbidity, mortality, and reoperation rate. The aim of this study was to evaluate the impact of a protective loop ileostomy in terms of short- and long-term postoperative morbidity, quantifying the stoma-related complications arising after stoma creation and stoma closure and the risk of permanent stoma. From January 2009 to January 2020, 149 patients with rectal cancer treated by anterior resection and protective ileostomy were enrolled in the study. A total of 113 (75.84%) patients were preoperatively treated with neoadjuvant radiochemotherapy. A clinically relevant anastomotic leak occurred in two patients (1.34%). The postoperative stoma complication rate was 6%. According to the Clavien classification, the stoma-related complication grade was I in seven patients (4.7%) and II in two patients (1.3%). A late stoma-related parastomal hernia occurred in one patient (0.67%). In 129 patients (86.57%), it was possible to close the stoma. Postoperative complications of stoma closure occurred in 12 patients (9.3%). The stoma closure complication grade was I in seven cases (5.43%), II in two cases (1.55%), and ≥3 in three cases (2.33%). Incisional hernia was the only late complication recorded in seven cases (5.42%). The permanent stoma rate was 13.43%. A protective ileostomy has a nonnegligible complication rate, but the rate of severe complications is low. Every effort should be made to clearly identify patients in whom the risk of anastomotic leakage justifies the stoma.

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