The Role of Heart Rate, Body Temperature, and Respiratory Rate in Predicting Anastomotic Leakage following Surgery for Rectal Cancer

Objective. To explore the value of the heart rate, body temperature, and respiratory rate in the early prediction of anastomotic leakage after rectal cancer surgery. Methods. Clinical data from patients with rectal cancer who underwent anterior rectal resection in the Department of Gastroenterology, Renmin Hospital of Wuhan University, from January 2017 to December 2019 were collected and analyzed retrospectively. Based on the occurrence of anastomotic leakage after surgery, the patients were divided into two groups: those with and without anastomotic leakage. The quantitative values of the heart rate, body temperature, and respiration rate at day 7 postsurgery were compared between the two groups. The ROC curve was used to analyze their role in the early prediction of anastomotic leakage. Results. Among 441 patients with rectal cancer, 30 (6.81%) had clinical anastomotic leakage and were diagnosed at 7 ± 3 days postsurgery. Within 7 days postsurgery, the heart rate, body temperature, and respiratory rate in the anastomotic leakage group were higher than those in the nonanastomotic leakage group. The differences in heart rate (1-5 d), body temperature (2-7 d), and respiratory rate (1-7 d) were statistically significant ( P < 0.05 ). The three ROC curves were drawn, respectively. The predictive value of the heart rate is greatest at days 2-3 postsurgery. The predictive value of the body temperature is greatest at days 4-6 postsurgery. The predictive value of the respiratory rate is best at days 1-4 postsurgery. Conclusion. The changes of vital signs (heart rate, body temperature, and respiratory rate) have a certain value in the early prediction of anastomotic leakage after rectal cancer surgery. Observation of postoperative vital signs at 7 days postsurgery is helpful for the early diagnosis of anastomotic leakage.

Download Full-text

Influence of Conversion and Anastomotic Leakage on Survival in Rectal Cancer Surgery; Retrospective Cross-sectional Study

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-018-3931-6 ◽

2018 ◽

Vol 23 (10) ◽

pp. 2007-2018 ◽

Cited By ~ 7

Author(s):

Edgar J. B. Furnée ◽

◽

Tjeerd S. Aukema ◽

Steven J. Oosterling ◽

Wernard A. A. Borstlap ◽

...

Keyword(s):

Rectal Cancer ◽

Anastomotic Leakage ◽

Cross Sectional Study ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Sectional Study ◽

Cross Sectional

Download Full-text

The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02432-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Yu Mu ◽

Linxian Zhao ◽

Hongyu He ◽

Huimin Zhao ◽

Jiannan Li

Keyword(s):

Rectal Cancer ◽

Anastomotic Leakage ◽

Meta Analysis ◽

Operation Time ◽

Postoperative Hospital Stay ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Anastomotic Leakage Rate ◽

Protective Ileostomy ◽

Clinically Significant

Abstract Background Protective ileostomy is always applied to avoid clinically significant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This meta-analysis aims to analyze the efficacy of ileostomy on laparoscopic rectal cancer surgery. Methods Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to May 07, 2021. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. We applied Review Manager software to perform this meta-analysis. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale. Results We collected a total of 1203 references, and seven studies were included using the research methods. The clinically significant anastomotic leakage rate was significantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30–0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I2 = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no significant difference between the ileostomy and non-ileostomy groups. Conclusion The results demonstrated that protective ileostomy could decrease the clinically significant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time. The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis.

Download Full-text

Risk factors for anastomotic leakage and stricture following rectal cancer surgery: A retrospective cohort study

Annals of Medical Research ◽

10.5455/annalsmedres.2020.08.889 ◽

2021 ◽

Vol 28 (2) ◽

pp. 352

Author(s):

Mehmet Usta ◽

Arif Cekic

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Cohort Study ◽

Anastomotic Leakage ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cancer Surgery ◽

Rectal Cancer Surgery

Download Full-text

Distribution of Pediatric Vital Signs in the Emergency Department: A Nationwide Study

Children ◽

10.3390/children7080089 ◽

2020 ◽

Vol 7 (8) ◽

pp. 89

Author(s):

Woori Bae ◽

Kyunghoon Kim ◽

Bongjin Lee

Keyword(s):

Emergency Department ◽

Heart Rate ◽

Body Temperature ◽

Respiratory Rate ◽

Life Support ◽

Vital Signs ◽

Reference Ranges ◽

Normal Body Temperature ◽

Heart Rates ◽

Normal Body

To effectively use vital signs as indicators in children, the magnitude of deviation from expected vital sign distribution should be determined. The purpose of this study is to derive age-specific centile charts for the heart rate and respiratory rate of the children who visited the emergency department. This study used the Korea’s National Emergency Department Information System dataset. Patients aged <16 years visiting the emergency department between 1 January 2016 and 31 December 2017 were included. Heart rate and respiratory rate centile charts were derived from the population with normal body temperature (36 to <38 °C). Of 1,901,816 data points retrieved from the database, 1,454,372 sets of heart rates and 1,458,791 sets of respiratory rates were used to derive centile charts. Age-specific centile charts and curves of heart rates and respiratory rates showed a decline in heart rate and respiratory rate from birth to early adolescence. There were substantial discrepancies in the reference ranges of Advanced Paediatric Life Support and Pediatric Advanced Life Support guidelines. Age-based heart rate and respiratory rate centile charts at normal body temperature, derived from children visiting emergency departments, serve as new evidence-based data and can be used in follow-up studies to improve clinical care for children.

Download Full-text

Leakage after Surgery for Rectum Cancer: Inconsistency in Reporting to the Danish Colorectal Cancer Group

Surgery Research and Practice ◽

10.1155/2015/376540 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5

Author(s):

L. Borly ◽

M. B. Ellebæk ◽

N. Qvist

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Anastomotic Leakage ◽

Leakage Rate ◽

Cancer Surgery ◽

Rectal Cancer Surgery ◽

Prognostic Impact ◽

Cancer Specific Survival ◽

Cancer Group ◽

Core Questions

Purpose. Anastomotic leakage accounts for up to 1/3 of all fatalities after rectal cancer surgery. Evidence suggests that anastomotic leakage has a negative prognostic impact on local cancer recurrence and long-term cancer specific survival. The reported leakage rate in 2011 in Denmark varied from 7 to 45 percent. The objective was to clarify if the reporting of anastomotic leakage to the Danish Colorectal Cancer Group was rigorous and unequivocal.Methods. An Internet-based questionnaire was e-mailed to all Danish surgical departments, who reported to Danish Colorectal Cancer Group (DCCG) in 2011. There were 23 questions. Four core questions were whether pelvic collection, fecal appearance in a pelvic drain, rectovaginal fistula, and “watchfull” waiting patients were reported as anastomotic leakage.Results. Fourteen out of 17 departments, who in 2011 according to DDCG performed rectal cancer surgery, answered the questionnaire. This gave a response rate of 82%. In three of four core questions there was disagreement in what should be reported as anastomotic leakage.Conclusion. The reporting of anastomotic leakage to the Danish Colorectal Cancer Group was not rigorous and unequivocal. The reported anastomotic leakage rate in Danish Colorectal Cancer Group should be interpreted with caution.

Download Full-text