Abstract
PurposeAnastomotic leakage is one of the most serious postoperative complications associated with surgery for rectal cancer. The present study aimed to identify the protective characteristics and risk factors associated with anastomotic leakage after low anterior resection for rectal cancer.MethodsThis was a retrospective, single-center study conducted between January 2009 and December 2017 at our institution. In total, 136 rectal cancer patients who underwent low anterior resection were included in the study. We analyzed preoperative and intraoperative factors. In addition, the pelvic dimensions were measured using computed tomography in all cases.ResultsAmong the 136 patients, anastomotic leakage occurred in 21 (15.4%), including 18 males and 3 females. The median body mass index was 21.1 kg/m2. The construction of a covering stoma was found to be a protective factor. In addition, the operation time (≥ 373 min), intraoperative blood loss (≥ 105 ml), and size of the pelvic inlet (≥ 113 mm) were identified as risk factors for anastomotic leakage.ConclusionThe construction of a covering stoma was a possible protective factor. However, a longer operation time, higher intraoperative blood loss, and larger pelvic inlet dimensions were possible risk factors for developing anastomotic leakage after low anterior resection in patients with rectal cancer.
Highlights
Advances in surgical procedures and adjuvant therapies have made sphincter-preserving surgery the standard operation for most patients with rectal cancer
Anastomotic leakage (AL) is a postoperative complication that occurs in patients who undergo low anterior resection (LAR) for rectal cancer [4,5,6]
We examined the following variables that represented protective and risk factors for AL: sex, age, body mass index (BMI), tumor location, neutrophil-to-lymphocyte ratio (NLR), lymphocyteto-monocyte ratio (LMR), serum albumin (Alb), UICC-T factor, UICC-stage, diverting stoma construction, use of an intraluminal drain, operating time, intraoperative blood loss, tumor size, and laparotomy
Summary
Advances in surgical procedures and adjuvant therapies have made sphincter-preserving surgery the standard operation for most patients with rectal cancer. Heald et al introduced a new method called total mesorectal excision (TME) for the treatment of rectal cancer. TME as a novel surgical method is important for preventing injury to the fascia propria of Anastomotic leakage (AL) is a postoperative complication that occurs in patients who undergo low anterior resection (LAR) for rectal cancer [4,5,6]. Reported risk factors for AL during surgery include the operation time, amount of intraoperative blood loss, and blood transfusion [13, 14].
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