Retrospective Risk Analysis for Anastomotic Leakage Following Laparoscopic Rectal Cancer Surgery in a Single Institute
| Autor: | Hiroaki Nakamura, Naoya Kimura, Masatsugu Hiraki, Toshiya Tanaka, Kenji Kitahara, Eiji Sadashima, Hirokazu Noshiro, Kohei Yamada, Keiichiro Okuyama, Tatsuya Manabe, Seiji Sato, Satomi Nakamura, Osamu Ikeda, Koutaro Yamaji, Atsushi Miyoshi |
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| Rok vydání: | 2019 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Anastomotic Leak Anastomosis Risk Assessment 03 medical and health sciences 0302 clinical medicine medicine Humans Aged Retrospective Studies Aged 80 and over Univariate analysis business.industry Rectal Neoplasms Incidence (epidemiology) Anastomosis Surgical Gastroenterology Retrospective cohort study Odds ratio Middle Aged medicine.disease Prognosis Confidence interval Surgery Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Laparoscopy business Follow-Up Studies |
| Zdroj: | Journal of gastrointestinal cancer. 51(3) |
| ISSN: | 1941-6636 |
| Popis: | Anastomotic leakage (AL) is one of the most serious complications after laparoscopic low anterior resection (LALAR) for rectal cancer. The aim of the present study was to investigate the risk factors for AL after LALAR.A retrospective study was conducted of 103 patients who underwent LALAR in a single institute between October 2008 and January 2018. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with AL.The overall incidence of AL was 9.7% (10/103). After anastomosis using the double-stapling technique, a transanal tube was placed in 88 patients (85.4%). A diverting stoma was created in 26 patients (25.2%). The univariate analysis showed that a younger age (P = 0.014), higher stage (P = 0.048), deeper depth of tumor invasion (P = 0.028), larger tumor circumference (P = 0.024), longer operation time (P = 0.015), and early postoperative diarrhea (P = 0.002) were associated with AL. The multivariate logistic regression analysis revealed early postoperative diarrhea (odds ratio [OR] 16.513, 95% confidence interval [CI] 2.393-113.971, P = 0.004) a younger age (10-year increments; OR 0.351, 95% CI 0.147-0.839, P = 0.019), operative time (10-min increments; OR 1.089, 95% CI 1.012-1.172, P = 0.022), and higher stage (OR 10.605, 95% CI 1.279-87.919, P = 0.029) were independent risk factors for AL CONCLUSION: Our findings suggest that tumor progression accompanied by a high stage, long operative time, and insufficient bowel preparation and early postoperative diarrhea due to a large tumor circumference may be risk factors of AL after LALAR for rectal cancer. |
| Databáze: | OpenAIRE |
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