Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique.
J Anus Rectum Colon
; 7(3): 196-205, 2023.
Article
en En
| MEDLINE
| ID: mdl-37496564
ABSTRACT
Objectives:
Anastomotic leakage (AL) is a serious complication associated with morbidity, mortality, and poor prognosis. This study aimed to identify the risk factors and predictive biomarkers for AL after colorectal surgery with double stapling technique (DST) anastomosis.Methods:
We retrospectively analyzed 331 patients who underwent elective colorectal cancer surgery with DST anastomosis between April 2012 and July 2021. Patient-, tumor-, and surgery-related variables were examined using univariate and multivariate analyses to identify the risk factors for AL. Postoperative inflammatory biomarkers were also analyzed to identify the predictive factors for AL.Results:
AL occurred in 28 (8.5%) patients. In multivariate analysis, male sex, a history of diabetes mellitus and high ligation of inferior mesenteric artery (IMA) were significant risk factors for AL. Serum C-reactive protein (CRP) levels on postoperative day (POD) 3 and 7 were significantly correlated with AL (OR; 95% CI, 1.134; 1.044-1.232, p = 0.003, and 1.154; 1.036-1.286, p = 0.009, respectively). The cut-off value of CRP on POD 3 was 10.91 mg/dL (sensitivity 0.714, specificity 0.835, positive predictive value [PPV] 0.290, and negative predictive value [NPV] 0.969). The cut-off value of CRP on POD 7 was 4.58 mg/dL (sensitivity 0.821, specificity 0.872, PPV 0.377, and NPV 0.981).Conclusions:
Male sex, a history of diabetes mellitus and high ligation of IMA were risk factors for AL in colorectal cancer surgery with DST anastomosis. The predictive biomarkers for cases without AL were CRP levels on POD 3 and 7.
Texto completo:
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Base de datos:
MEDLINE
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Anus Rectum Colon
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón