Risk Factors of Anastomotic Leakage and Long-Term Survival After Colorectal Surgery

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.

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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).

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Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

World Journal of Surgical Oncology ◽

10.1186/s12957-020-01968-8 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Marius Kryzauskas ◽

Augustinas Bausys ◽

Austeja Elzbieta Degutyte ◽

Vilius Abeciunas ◽

Eligijus Poskus ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Anastomotic Leakage ◽

Cancer Surgery ◽

Colorectal Cancer Surgery ◽

Term Survival ◽

Long Term Survival

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Long-term survival after colorectal surgery associated with buffy-coat-poor and leucocyte-depleted blood transfusion: a follow-up study

The Lancet ◽

10.1016/s0140-6736(05)70935-1 ◽

2005 ◽

Vol 365 (9460) ◽

pp. 681-682 ◽

Cited By ~ 25

Author(s):

L JENSEN ◽

E PUHO ◽

L PEDERSEN ◽

F MORTENSEN ◽

H SORENSEN

Keyword(s):

Colorectal Surgery ◽

Blood Transfusion ◽

Buffy Coat ◽

Term Survival ◽

Long Term Survival ◽

Follow Up Study

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Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01506-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lytfi Krasniqi ◽

Mads P. Kronby ◽

Lars P. S. Riber

Keyword(s):

Risk Factors ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Significant Risk ◽

Valve Prosthesis ◽

Term Survival ◽

Long Term Survival ◽

All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

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The influence of thrombophilia on the long-term survival of patients with a history of venous thromboembolism

Thrombosis and Haemostasis ◽

10.1160/th12-05-0361 ◽

2013 ◽

Vol 109 (01) ◽

pp. 79-84 ◽

Cited By ~ 12

Author(s):

Sylvia Reitter-Pfoertner ◽

Thomas Waldhoer ◽

Michaela Mayerhofer ◽

Ernst Eigenbauer ◽

Cihan Ay ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Multivariable Analysis ◽

Factor V Leiden ◽

Arterial Disease ◽

Factor V ◽

Term Survival ◽

Long Term Survival ◽

History Of

SummaryData on the long-term survival following venous thromboembolism (VTE) are rare,and the influence of thrombophilia has not been evaluated thus far. Our aim was to assess thrombophilia-parameters as predictors for long-term survival of patients with VTE. Overall, 1,905 outpatients (99 with antithrombin-, protein C or protein S deficiency, 517 with factor V Leiden, 381 with elevated factor VIII and 160 with elevated homocysteine levels, of these 202 had a combination and 961 had none of these risk factors) were included in the study between September 1, 1994 and December 31, 2007. Retrospective survival analysis showed that a total of 78 patients (4.1%) had died during the analysis period, among those four of definite or possible pulmonary embolism and four of bleeding. In multivariable analysis including age and sex an association with increased mortality was found for hyperhomocysteinemia (hazard ratio 2.0 [1.1.-3.5]) whereas this was not the case for all other investigated parameters. We conclude that the classical hereditary thrombophilia risk factors did not have an impact on the long-term survival of patients with a history of VTE. Thus our study supports the current concept that thrombophilia should not be a determinant for decision on long term anticoagulation. However, hyperhomocysteinaemia, known as a risk factor for recurrent VTE and arterial disease, might impact survival.

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