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International Journal of Colorectal Disease

Published in:

01-02-2018 | Original Article

Calcification of the iliac arteries: a marker for leakage risk in rectal anastomosis—a blinded clinical trial

Authors: Julius Pochhammer, Fridolin Tröster, Gunnar Blumenstock, Julienne Closset, Stefanie Lang, Marie-Pascale Weller, Michael Schäffer

Published in: International Journal of Colorectal Disease | Issue 2/2018

Abstract

Purpose

Anastomotic leakage (AL) is associated with increased morbidity and mortality after colorectal surgery. Calcification of the arteries has been identified as a risk factor for cardiovascular events and can be reliably measured on computed tomography using software assistance. The aim of this prospective study was to prove the value of calcium scoring of the iliac arteries as a predictor of AL after rectal anastomosis.

Methods

Consecutive patients who underwent colorectal resection with rectal anastomosis were analyzed. Diagnostic computed tomography images were used to detect calcification of the arteries supplying the rectal anastomosis. Logistic regression analysis was used to determine the relationship between vascular calcification and AL.

Results

Of 139 included and analyzed patients, AL occurred in 15 (11%). The volume and calcium scores were significantly higher in the infrarenal aorta, the left and right common iliac artery, and the left internal iliac artery. In univariate analysis, calcification of the left internal iliac artery and both internal iliac arteries combined correlated with the occurrence of the primary endpoint. A receiver operating curve analysis led to the cut-off values of 30 and 6 for the volume score and calcium score, respectively. They provide a negative predictive value of 0.97 and a positive predictive value of 0.19.

Conclusions

Calcification in the iliac arteries appears to be a good marker for the risk of leakage after rectal anastomosis. The calcification scoring system is easy to calculate after computed tomography and may aid in patient selection to create a protective ileostomy.

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Title: Calcification of the iliac arteries: a marker for leakage risk in rectal anastomosis—a blinded clinical trial
Authors: Julius Pochhammer
Fridolin Tröster
Gunnar Blumenstock
Julienne Closset
Stefanie Lang
Marie-Pascale Weller
Michael Schäffer
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2949-7

2024 ASCO Annual Meeting

Springer Medicine

Calcification of the iliac arteries: a marker for leakage risk in rectal anastomosis—a blinded clinical trial

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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