Risk Factors for Anastomotic Leakage After Laparoscopic Resection for Rectal Cancer
Posted: Tuesday, September 4, 2018
Male patients with rectal cancer and a history of ischemic heart disease may be at an increased risk for anastomotic leakage after laparoscopic surgery, according to a retrospective study published in BMC Gastroenterology. Seiichi Shinji, MD, PhD, of Nippon Medical School, Tokyo, and colleagues believe their findings may lead to development of agents to prevent this complication and reduce the need for a permanent stoma.
“Anastomotic leakage is the most serious and common complication of surgery for rectal cancer [rate of 11.6%], and associated risk factors remain unknown despite developments in laparoscopic surgery,” wrote Dr. Shinji and colleagues.
Using a database of consecutive colorectal resections occurring between 2011 and 2015 at Nippon Medical School Hospital, the researchers identified 154 patients with rectal cancer who were treated by elective laparoscopic anastomotic resection. Overall, 18 patients (11.7%) experienced anastomotic leakage, and 5 of these patients (27.8%) required revised laparotomy. In this study, male patients alone experienced anastomotic leakage.
A univariate analysis of male patients (n = 100) indicated a strong association between anastomotic leakage and preoperative creatinine values (P = .03) and a history of ischemic heart disease (P = .012). In addition, a multivariate analysis revealed a history of ischemic heart disease (P = .025) to be an independent risk factor for anastomotic leakage. The study also found that patients with low anastomotic resection (P = .06) and transanal drainage experienced an increase in the frequency of anastomotic leakage.