A Multivariate Analysis of Anastomotic Stenosis After Anterior Resection for Rectal Carcinoma

Abstract Anastomotic dehiscence (AD) requiring reoperation is the most severe complication following anterior rectal resection. We performed a systematic review on studies that describe AD requiring reoperation and its subsequent mortality after anterior resection for rectal carcinoma. A systematic search was performed on published literature. Data on the definition and rate of AD, the number of ADs requiring reoperation, the mortality caused by AD, and the overall postoperative mortality were pooled and analyzed. A total of 39 studies with 24,232 patients were analyzed. The studies varied in incidence and definition of AD. Systematic review of the data showed that the overall rate of AD was 8.6%, and the rate of AD requiring reoperation was 5.4%. The postoperative mortality caused by AD was 0.4%, and the overall postoperative mortality was 1.3%. We found considerable risk and mortality for AD requiring reoperation, which largely contributed to the overall postoperative mortality.

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The association of age with decline in renal function after low anterior resection and loop ileostomy for rectal cancer: a retrospective cohort prognostic factor study

BMC Geriatrics ◽

10.1186/s12877-020-02001-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Amal Rhemouga ◽

Stefan Buettner ◽

Wolf O. Bechstein ◽

Guido Woeste ◽

Teresa Schreckenbach

Keyword(s):

Rectal Cancer ◽

Rectal Carcinoma ◽

Anterior Resection ◽

Low Anterior Resection ◽

Older Patients ◽

Retrospective Cohort ◽

Loop Ileostomy ◽

Linear Regression Analysis ◽

Multivariate Linear Regression Analysis ◽

Group B

Abstract Background Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients. Methods A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis. Results SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal. Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68). Conclusion DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.

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Locoregional recurrence in patients with anastomotic leakage after anterior resection for rectal carcinoma

Colorectal Disease ◽

10.1046/j.1463-1318.2001.00232.x ◽

2001 ◽

Vol 3 (3) ◽

pp. 154-160 ◽

Cited By ~ 59

Author(s):

S. Merkel ◽

W. Y. Wang ◽

O. Schmidt ◽

O. Dworak ◽

CH. Wittekind ◽

...

Keyword(s):

Anastomotic Leakage ◽

Rectal Carcinoma ◽

Anterior Resection ◽

Locoregional Recurrence

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A Successful Case of Conservative Therapy with Estriol and Chloramphenicol for Rectovaginal Fistula after Low Anterior Resection for Rectal Carcinoma

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.70.424 ◽

2017 ◽

Vol 70 (6) ◽

pp. 424-427

Author(s):

Shinichi Yoshioka ◽

Mutsumi Fukunaga ◽

Masaki Tsujie ◽

Shigeyuki Ueshima ◽

Riichiro Nezu

Keyword(s):

Rectal Carcinoma ◽

Anterior Resection ◽

Rectovaginal Fistula ◽

Low Anterior Resection ◽

Conservative Therapy ◽

Successful Case

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Flush aortic tieversus selective preservation of the ascending left colic artery in low anterior resection for rectal carcinoma

British Journal of Surgery ◽

10.1002/bjs.1800790730 ◽

1992 ◽

Vol 79 (7) ◽

pp. 680-682 ◽

Cited By ~ 59

Author(s):

A. P. Corder ◽

N. D. Karanjia ◽

J. D. Williams ◽

R. J. Heald

Keyword(s):

Rectal Carcinoma ◽

Anterior Resection ◽

Low Anterior Resection ◽

Colic Artery ◽

Left Colic Artery ◽

Selective Preservation

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Recurrent rectal carcinoma after anterior resection and rectal stapling

British Journal of Surgery ◽

10.1002/bjs.1800710206 ◽

1984 ◽

Vol 71 (2) ◽

pp. 98-100 ◽

Cited By ~ 27

Author(s):

B. Anderberg ◽

P. Enblad ◽

R. Sjödahl ◽

J. Wetterfors

Keyword(s):

Rectal Carcinoma ◽

Anterior Resection

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Heterotopic Ossification in Rectal Carcinoma: Report of a Case and Review of the Literature

Case Reports in Oncology ◽

10.1159/000452297 ◽

2016 ◽

Vol 9 (3) ◽

pp. 698-704 ◽

Cited By ~ 2

Author(s):

Jiro Shimazaki ◽

Akira Takemura ◽

Kiyotaka Nishida ◽

Hideki Kajiyama ◽

Mitsugi Shimoda ◽

...

Keyword(s):

Heterotopic Ossification ◽

Histological Examination ◽

Rectal Carcinoma ◽

Anterior Resection ◽

Low Anterior Resection ◽

Virtual Colonoscopy ◽

Rectal Wall ◽

Medical Center ◽

Uneventful Recovery ◽

Spindle Cells

Heterotopic ossification in colorectal carcinoma is extremely rare. This report presents the case of a 57-year-old male who had undergone a low anterior resection following a diagnosis of rectal carcinoma. Histological examination showed heterotopic ossification in the tumor. The patient was referred to Ibaraki Medical Center, Tokyo Medical University, with a diagnosis of rectal carcinoma by a local physician. Abdominal computed tomography revealed thickening of the rectal wall with calcified deposits, and virtual colonoscopy showed stenosis with a mass in the rectum. The patient underwent a low anterior resection and diverting ileostomy in May 2014. Histological examination of the excised tumor showed moderately differentiated adenocarcinoma and an infiltration of spindle cells with numerous foci of osteoid and ossification, with osteoblastic rimming in the stroma. Immunohistochemical analysis of these spindle cells and osteoblasts revealed negative staining for AE1/AE3, suggesting a reactive change. There was metastasis in 1 of the 12 lymph nodes, and the tumor was diagnosed as stage IIIB (T4a, N1a, M0) rectal carcinoma. The patient had an uneventful recovery and was followed up at our outpatient clinic. In conclusion, the malignant potential of heterotopic ossification in rectal carcinoma has not been determined. However, heterotopic ossification is induced by tumor progression in a microenvironment, suggesting a high tumor malignity. The patient should be carefully monitored after surgery in terms of improved patient outcome.

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