Higher modified Glasgow Prognostic Score and multiple stapler firings for rectal transection are risk factors for anastomotic leakage after low anterior resection in rectal cancer

DOI 機関リポジトリ Web Site PubMed 参考文献17件 オープンアクセス
  • Sakamoto Wataru
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Ohki Shinji
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Kikuchi Tomohiro
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Okayama Hirokazu
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Fujita Shotaro
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Endo Hisahito
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Saito Motonobu
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Saze Zenichiro
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Momma Tomoyuki
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University
  • Kono Koji
    Department of Gastrointestinal Tract Surgery, Fukushima Medical University

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<p>Objective: Anastomotic leakage (AL) is one of the most devastating complications of rectal cancer surgery. Not only does AL result in reduced quality of life, extended hospitalization and impaired defecatory function, it also has a high local recurrence rate. In this study, we investigated risk factors for AL as it may help to decrease its occurrence and improve patient outcomes. </p><p>Methods: This study was a retrospective, single-institution study of rectal cancer patients who underwent elective low anterior resection between April 2002 and February 2018 at Fukushima Medical University Hospital. Patients were divided into two groups according to the presence of AL. Patient-, tumor-, and surgery-related variables were examined using univariate and multivariate analyses. </p><p>Results: One hundred sixty-one patients, average age 63.5±11.5 years, were enrolled in the study. The overall AL rate was 6.8% (11/161). In the univariate analysis, modified Glasgow Prognostic Score (mGPS)=2 (p=0.003), use of multiple staplers (≥3 firings) for rectal transection (p=0.001) and intraoperative bleeding (≥250 g) were significantly associated with AL incidence. Multivariate analysis identified that mGPS = 2 (odds ratio [OR]: 19.6, 95% confidence interval [CI]: 2.96-125.00, p=0.002) and multiple firings (OR: 18.19, CI: 2.31-111.11, p=0.002) were independent risk factors for AL.</p><p>Conclusion: Higher mGPS score and multiple firings were independent risk factors for AL. </p>

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