Abstract
BackgroundPostoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer. AL can potentially affect short-term patient outcomes and long-term prognosis. This study aimed to explore the risk factors and long-term survival of symptomatic AL after laparoscopic LAR for rectal cancer.MethodsFrom May 2009 to May 2015, 298 consecutive patients who underwent laparoscopic LAR for rectal cancer with or without a defunctioning stoma were included in this study. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for symptomatic AL. Survival analysis was performed using Kaplan–Meier curves, and log-rank tests were used for group comparisons.ResultsAmong the 298 patients enrolled in this study, symptomatic AL occurred in eight (2.7%) patients. The univariate analysis showed that age of ≤65 years (P = 0.048), neoadjuvant therapy (P = 0.095), distance from the anal verge (P = 0.078), duration of operation (P = 0.001), and pathological tumor (T) category (P = 0.004) were associated with symptomatic AL. The multivariate analysis demonstrated that prolonged duration of operation (P = 0.010) was an independent risk factor for symptomatic AL after laparoscopic LAR for rectal cancer. No statistically significant differences were observed in the 3-year (P = 0.785) and 5-year (P = 0.979) overall survival rates.ConclusionsA prolonged duration of operation increased the risk of symptomatic AL after laparoscopic LAR for rectal cancer. An impact of symptomatic AL on a long-term survival was not observed in this study; however, further studies are required.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (ChiCTR2000033413) on May 31, 2020.
Highlights
Postoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer
The present study has two clinical objectives: (1) the primary objective was to identify the risk factors of symptomatic AL after laparoscopic LAR based on patient, surgery, and tumor-related variables, and (2) the secondary objective was to assess the impact of symptomatic AL on 3- and 5-year overall survival rates
Eight (2.7%) patients were diagnosed with symptomatic AL, and no grade A patients were included in this study
Summary
Postoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer. Postoperative anastomotic leakage (AL) after low anterior resection (LAR) for rectal cancer is a common and devastating complication, and the reported incidence of AL varies from 2.2 to 18.6% [1,2,3,4,5,6,7,8]. It significantly increases mortality rates and health care costs in short time [3, 9] and has higher local recurrence during long-term follow-up [10]. The present study has two clinical objectives: (1) the primary objective was to identify the risk factors of symptomatic AL after laparoscopic LAR based on patient, surgery, and tumor-related variables, and (2) the secondary objective was to assess the impact of symptomatic AL on 3- and 5-year overall survival rates
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