Risk Factors for Symptomatic Anastomotic Leakage After Low Anterior Resection for Rectal Cancer with 30 Gy/10 f/2 w Preoperative Radiotherapy

Abstract Background Postoperative 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. Methods From 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. Results Among 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. Conclusions A 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 registration This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000033413) on May 31, 2020.

Download Full-text

Determining the protective characteristics and risk factors for the development of anastomotic leakage after low anterior resection for rectal cancer

Surgery Today ◽

10.1007/s00595-020-02133-0 ◽

2020 ◽

Author(s):

Nobuaki Suzuki ◽

Shin Yoshida ◽

Shinobu Tomochika ◽

Yuki Nakagami ◽

Yoshitaro Shindo ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Protective Factor ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Pelvic Inlet ◽

Covering Stoma

Abstract Purpose Anastomotic 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. Methods This 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. Results Among 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. Conclusion The 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.

Download Full-text

Risk Factors of Symptomatic Anastomotic Leakage and its Impacts on Long Term Survival after Laparoscopic Low Anterior Resection for Rectal Cancer: A Retrospective Single Center Study

10.21203/rs.3.rs-169861/v1 ◽

2021 ◽

Author(s):

Xinyu Qi ◽

Maoxing Liu ◽

Kai Xu ◽

Pin Gao ◽

Fei Tan ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Survival Analysis ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Term Survival ◽

Long Term Survival ◽

Duration Of Operation

Abstract Background: Postoperative 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.Methods: From 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.Results: Among the 298 patients enrolled in this study, symptomatic AL occurred in eight patients (2.7%). The univariate analyses showed that the age≤65 (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 only the duration of operation (P = 0.010) was an independent risk factor for symptomatic AL after laparoscopic LAR for rectal cancer. In the survival analysis, no statistically significant differences in the 3-year (P = 0.785) and 5-year (P = 0.979) overall survival rates were observed.Conclusions: A prolonged duration of operation increased the risk of symptomatic AL after laparoscopic LAR for rectal cancer. An impact of symptomatic AL on long-term survival was not observed in this study, but it needs to be studied more.Trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR2000033413).

Download Full-text

Decreasing Anastomotic Leakage Rate Following Preoperative Radiotherapy and Low Anterior Resection for Rectal Cancer: Reply

World Journal of Surgery ◽

10.1007/s00268-010-0802-z ◽

2010 ◽

Vol 35 (1) ◽

pp. 241-241 ◽

Cited By ~ 1

Author(s):

Jin Gu ◽

Lin Wang

Keyword(s):

Rectal Cancer ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Preoperative Radiotherapy ◽

Leakage Rate ◽

Anastomotic Leakage Rate

Download Full-text

Transanal tube placement for prevention of anastomotic leakage following low anterior resection for rectal cancer: a systematic review and meta-analysis

Annals of Surgical Treatment and Research ◽

10.4174/astr.2015.89.6.313 ◽

2015 ◽

Vol 89 (6) ◽

pp. 313 ◽

Cited By ~ 10

Author(s):

Gi Won Ha ◽

Hyun Jung Kim ◽

Min Ro Lee

Keyword(s):

Systematic Review ◽

Rectal Cancer ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Low Anterior Resection ◽

Meta Analysis ◽

Tube Placement ◽

Transanal Tube

Download Full-text

Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study). A nationwide retrospective study of the Italian Society of Surgical Oncology – Colorectal Cancer Network Collaborative Group

Colorectal Disease ◽

10.1111/codi.15997 ◽

2021 ◽

Author(s):

Maurizio Degiuli ◽

Ugo Elmore ◽

Raffaele De Luca ◽

Paola De Nardi ◽

Mariano Tomatis ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Rectal Cancer ◽

Retrospective Study ◽

Anastomotic Leakage ◽

Anterior Resection ◽

Surgical Oncology ◽

Italian Society ◽

Collaborative Group ◽

Cancer Network

Download Full-text

Quality of life after rectal cancer surgery (systematic review)

Koloproktologia ◽

10.33878/2073-7556-2021-20-1-59-67 ◽

2021 ◽

Vol 20 (1) ◽

pp. 59-67

Author(s):

A. B. Serebriy ◽

E. A. Khomyakov ◽

I. O. Nafedzov ◽

O. Yu. Fomenko ◽

E. G. Rybakov

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Life Quality ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Low Anterior Resection Syndrome

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.

Download Full-text