A Retrospective Study About the Effectiveness of Anastomosis With a Polyglycolic Acid Sheet in Colorectal Cancer.

Abstract

Introduction Anastomotic leakage is a serious complication in colon and rectal cancer surgeries, contributing to increased mortality rates and extended hospital stays. Despite various preventive measures, including intraoperative assessments and transanal drains, the incidence of anastomotic leakage remains a significant concern. This study investigates the potential efficacy of polyglycolic acid (PGA) sheets in reducing anastomotic leakage rates in gastrointestinal surgeries. Materials & methods A retrospective cohort study was conducted between January 2021 and January 2023 at Nagoya Tokushukai General Hospital, Ogaki Tokushukai Hospital, and Haibara General Hospital. A total of 239 patients undergoing colon or rectal cancer surgery were included. Anastomoses were performed with or without PGA sheets, and groups were compared using statistical analyses, including t-tests, Mann-Whitney U tests, and chi-square tests. The primary endpoint was the incidence of anastomotic leakage. Results Of the 239 patients, anastomotic leakage occurred in 14 (6%). The PGA use group (52 patients) showed no instances of anastomotic leakagewhile the PGA non-use group (187 patients) had 14 cases. Comparisons revealed significant differences in anastomotic leakage rates (p=0.04) between the two groups. Univariate analysis demonstrated a lower incidence of anastomotic leakage associated with PGA use (p=0.04). However, no significant differences were observed for transanal drainage (p=0.66), smoking (p=0.76), steroid use (p=1), and preoperative chemotherapy (p=0.07). Conclusion This study suggests that the use of PGA sheets in gastrointestinal anastomosis may contribute to a lower incidence of anastomotic leakage. The findings highlight the need for further prospective studies with a larger sample size, distinguishing between colon and rectum surgeries. Despite the limitations of this retrospective study, the observed reduction in anastomotic leakage frequency with PGA sheet use is noteworthy, emphasizing the potential significance of this approach in preventing a critical complication in colorectal surgeries.