Early postoperative pain as a marker of anastomotic leakage in colorectal cancer surgery
| Autor: | Martin Rutegård, Petrus Boström, Camilla Brorsson, Johan Svensson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Dehiscence Colorectal cancer Colon Population Anastomotic Leak 030230 surgery Anastomosis 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Anastomotic insufficiency Humans education Digestive System Surgical Procedures Retrospective Studies education.field_of_study Pain Postoperative business.industry Kirurgi Anastomosis Surgical Gastroenterology Rectum Retrospective cohort study Odds ratio Perioperative medicine.disease Confidence interval Colorectal surgery Surgery 030220 oncology & carcinogenesis Vital sign Original Article Leak business Colorectal Neoplasms |
| Zdroj: | International Journal of Colorectal Disease |
| Popis: | Purpose Even though anastomotic leakage after colorectal surgery is a major clinical problem in need of a timely diagnosis, early indicators of leakage have been insufficiently studied. We therefore conducted a population-based observational study to determine whether the patient’s early postoperative pain is an independent marker of anastomotic leakage. Methods By combining the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry, we retrieved prospectively collected data on 3084 patients who underwent anastomotic colorectal surgery for cancer in 2014–2017. Postoperative pain, measured with the numerical rating scale (NRS), was considered exposure, while anastomotic leakage and reoperation due to leakage were outcomes. We performed logistic regression to evaluate associations, estimating odds ratios (ORs) and 95% confidence intervals (CIs), while multiple imputation was used to handle missing data. Results In total, 189 patients suffered from anastomotic leakage, of whom 121 patients also needed a reoperation due to leakage. Moderate or severe postoperative pain (NRS 4–10) was associated with an increased risk of anastomotic leakage (OR 1.69, 95% CI 1.21–2.38), as well as reoperation (OR 2.17, 95% CI 1.41–3.32). Severe pain (NRS 8–10) was more strongly related to leakage (OR 2.38, 95% CI 1.44–3.93). These associations were confirmed in multivariable analyses and when reoperation due to leakage was used as an outcome. Conclusion In this population-based retrospective study on prospectively collected data, increased pain in the post-anaesthesia care unit is an independent marker of anastomotic leakage, possibly indicating a need for further diagnostic measures. |
| Databáze: | OpenAIRE |
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