scholarly journals Risk Factor Analysis for Anastomotic Leakage after Lower Rectal Cancer Resection: A Retrospective Single-Center Study

2020 ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Postoperative Blood Loss ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage

Abstract Background We investigated the correlation between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer. Methods A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR, and are the subjects of this retrospective study. Temporary ileostomy was performed for each patient.Results Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.0051), transanal hand-sewn anastomosis (p=0.0141), and operation procedure (p=0.0191) were significantly associated with the incidence of leakage. Multivariate analysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.0188), and drain type (p=0.0251) were significantly associated with the incidence of leakage. The propensity score analysis results showed that closed drainage was associated with 6.3 times more postoperative blood loss (mls) in patients experiencing anastomotic leakage compared with open drainage, in the inverse probability of treatment-weighted analysis.Conclusions Our results showed that underlying disease, transanal hand-sewn anastomosis, and the drain type may be risk factors for developing anastomotic leakage after LAR for lower rectal cancer. The notable finding was that the type of drainage was related to the incidence and volume of anastomotic leakage: open drainage was correlated with the incidence of leakage, and closed drainage was correlated with the volume of anastomotic leakage.

scholarly journals Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study

2020 ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage ◽  
Score Analysis

Abstract Background: We investigated the correlations between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer.Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were included in this retrospective study. Temporary ileostomy was performed in each patient.Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.005), transanal hand-sewn anastomosis (p=0.014), and operation procedure (p=0.019) were significantly associated with the occurrence of leakage. Multivariate analysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.019) and drain type (p=0.025) were significantly associated with the occurrence of leakage. Propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to inverse probability of treatment-weighted analysis.Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be risk factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with the less volume of postoperative drain discharge than open drain.

scholarly journals Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage ◽  
Score Analysis

Abstract Background We investigated the correlations between surgery-related factors and the incidence of anastomotic leakage after low anterior resection (LAR) for lower rectal cancer. Methods A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were enrolled in this retrospective study. Temporary ileostomy was performed in each patient. Results Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed a significant association between operative duration (p = 0.005), transanal hand-sewn anastomosis (p = 0.014), and operation procedure (p = 0.019) and the occurrence of leakage. Multivariate regression reanalysis showed that underlying disease (p = 0.044), transanal hand-sewn anastomosis (p = 0.019) and drain type (p = 0.025) were significantly associated with the occurrence of leakage. The propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to the inverse probability of treatment-weighted analysis. Conclusions Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be a risk and predictive factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with less volume of postoperative drain discharge than open drain.

scholarly journals Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study

2020 ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage ◽  
Score Analysis

Abstract Background: We investigated the correlations between surgery-related factors and the incidence of anastomotic leakage after low anterior resection (LAR) for lower rectal cancer.Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were enrolled in this retrospective study. Temporary ileostomy was performed in each patient.Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed a significant association between operative duration (p=0.005), transanal hand-sewn anastomosis (p=0.014), and operation procedure (p=0.019) and the occurrence of leakage. Multivariate regression reanalysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.019) and drain type (p=0.025) were significantly associated with the occurrence of leakage. The propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to the inverse probability of treatment-weighted analysis.Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be a risk and predictive factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with less volume of postoperative drain discharge than open drain.

scholarly journals Analysis of Risk Factor for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study

2020 ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage ◽  
Score Analysis

Abstract Abstract Background: We investigated the correlations between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer. Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were included in this retrospective study. Temporary ileostomy was performed in each patient. Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.005), transanal hand-sewn anastomosis (p=0.014), and operation procedure (p=0.019) were significantly associated with the occurrence of leakage. Multivariate analysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.019) and drain type (p=0.025) were significantly associated with the occurrence of leakage. Propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to inverse probability of treatment-weighted analysis . Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and drain type may be risk factors for anastomotic after LAR for lower rectal cancer. The notable finding was that the type of drainage was related to the occurrence of anastomotic leakage: closed drainage was correlated with the less volume of postoperative drain discharge than open drain.

scholarly journals Analysis of Risk Factors for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study

2020 ◽  
Author(s):  
Tetsushi Kinugasa ◽  
Sachiko Nagasu ◽  
Kenta Murotani ◽  
Tomoaki Mizobe ◽  
Takafumi Ochi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Propensity Score Analysis ◽  
Univariate Analysis ◽  
Underlying Disease ◽  
Lower Rectal Cancer ◽  
Open Drainage ◽  
Related Factors ◽  
Closed Drainage

Abstract Background: We investigated the correlations between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer.Methods: A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were included in this retrospective study. Temporary ileostomy was performed in each patient.Results: Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.0051), transanal hand-sewn anastomosis (p=0.0141), and operation procedure (p=0.0191) were significantly associated with the occurrence of leakage. Multivariate analysis showed that underlying disease (p=0.0440), transanal hand-sewn anastomosis (p=0.0188) and drain type (p=0.0251) were significantly associated with the occurrence of leakage. Propensity-score analysis showed that closed drainage was associated with 6.3 times with anastomotic leakage than open drainage in patients, according to inverse probability of treatment-weighted analysis. Conclusions: Our results indicate that underlying disease, transanal hand-sewn anastomosis, and drain type may be risk factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that the type of drainage was related to the occurrence of anastomotic leakage: closed drainage was correlated with the less volume of postoperative drain discharge than open drain.

scholarly journals Neutrophil-to-Lymphocyte Ratio is a Prognostic Predictive Factor for Local Advanced Lower Rectal Cancer Treated with Curative Surgical Treatment after Neoadjuvant Chemoradiotherapy: A Single-Center Retrospective Cohort Study

2021 ◽  
Author(s):  
Ryosuke Nakagawa ◽  
Shimpei Ogawa ◽  
Yuji Inoue ◽  
Takeshi Ohki ◽  
Yoshiko Bamba ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Operation Time ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lower Rectal Cancer ◽  
Curative Surgery ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Background: The neutrophil-to-lymphocyte ratio (NLR) correlates with relapse-free survival (RFS) and may be a predictor of recurrence in patients after curative surgery for colorectal cancer. This study aimed to analyze the long-term oncological outcomes of locally advanced lower rectal cancer treated with curative surgery after neoadjuvant chemoradiotherapy (nCRT) to examine the prognostic value of the NLR and to evaluate the fluctuation of pre- and post-CRT NLR as recurrence risk factors.Methods: Fifty-two patients who underwent curative surgery were enrolled between 2009 and 2016. A cut-off pre-CRT NLR of 3.20 was used based on receiver-operating characteristic curve analysis. The primary outcome was RFS. Factors influencing recurrence after treatment according to fluctuations between the pre- and post-CRT NLR were also analyzed.Results: Univariate analysis was performed using 17 clinicopathological factors thought to affect RFS. A significant difference was found in the pre-CRT NLR (hazard ratio [HR]: 7.626, 95% confidence interval [CI]: 2.760-21.06, p<0.0001), operation time (HR: 2.949, 95% CI: 1.137-7.646, p=0.0261), and pathological T stage (HR: 8.342, 95% CI: 2.458-28.306 p=0.0007). RFS according to the pre-CRT NLR using Kaplan–Meier analysis showed that the group with pre-CRT ≥3.20 had a lower 5-year RFS (p=0.001). A lower pre-CRT NLR resulted in a significantly higher recurrence rate, regardless of the increase or decrease in the pre- and post-CRT NLR.Conclusions: The pre-CRT NLR may be a predictor of prognosis in patients with locally advanced lower rectal cancer after nCRT.

scholarly journals Impact of intratumor heterogeneity on diffusion-weighted MRI as a prognostic indicator in lower rectal cancer

2020 ◽  
Author(s):  
Michihiro Kudou ◽  
Masayoshi Nakanishi ◽  
Yoshiaki Kuriu ◽  
Tomohiro Arita ◽  
Hiroki Shimizu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Heterogeneity ◽  
Univariate Analysis ◽  
Prognostic Indicator ◽  
Imaging Biomarker ◽  
Intratumor Heterogeneity ◽  
Lower Rectal Cancer ◽  
High Group ◽  
Free Survival ◽  
Poorly Differentiated

Abstract Background Diffusion-weighed MRI (DWI) has the potential to reveal intra-tumor pathological heterogeneity consisting of the stroma. The present study investigated the value of intra-tumor heterogeneity evaluated by DWI for predicting the survival of patients with lower rectal cancer (LRC). Methods A total of 172 LRC patients underwent radical surgery between 2009 and 2017. Patients with T1 tumors, distant metastasis, and no pre-operative MRI were excluded. Fifty-eight cases were targeted. Intra-tumor heterogeneity on DWI was quantified by an image analysis (MRI heterogeneous score of DWI: mrHSD). All enrolled cases were divided into two groups (high and low groups) according to median mrHSD. Results Median mrHSD was 0.457 (0.170–0.823), with a higher score indicating a more heterogeneous pattern on DWI. The frequency of a clinical diagnosis of lymph node metastasis and extramural vascular invasion was higher in the high group. Three-year overall survival (OS) and relapse-free survival (RFS) rates were significantly higher in the low group than in the high group (OS: 100% vs 84.6%, p = 0.012; RFS: 85.9% vs 55.6%, p = 0.027). A univariate analysis of RFS showed that the RFS rates of poorly differentiated LRC, a positive circumferential resection margin on MRI, and high mrHSD were worse (p = 0.097, 0.086, and 0.049). A multivariate analysis revealed that high mrHSD tended to be an independent factor for predicting post-operative recurrence (HR: 2.836, p = 0.060). Conclusion The quantitative evaluation of intratumor heterogeneity on DWI has potential as an imaging biomarker for predicting post-operative recurrence.

Sign in / Sign up

Export Citation Format

Share Document