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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2018

Open Access 01-12-2018 | Research article

Male sex and history of ischemic heart disease are major risk factors for anastomotic leakage after laparoscopic anterior resection in patients with rectal cancer

Authors: Seiichi Shinji, Yoshibumi Ueda, Takeshi Yamada, Michihiro Koizumi, Yasuyuki Yokoyama, Goro Takahashi, Masahiro Hotta, Takuma Iwai, Keisuke Hara, Kohki Takeda, Mikihiro Okusa, Hayato Kan, Eiji Uchida, Hiroshi Yoshida

Published in: BMC Gastroenterology | Issue 1/2018

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Abstract

Background

Anastomotic leakage (AL) is the most serious and common complication of surgery for rectal cancer, and associated risk factors remain unknown despite developments in laparoscopic surgery. The present study aimed to determine risk factors for AL after laparoscopic anterior resection (AR) of rectal cancer.

Methods

This retrospective cohort study extracted information from a prospective database of all consecutive colorectal resections that proceeded at Nippon Medical School Hospital between January 2011 and December 2015 (n = 865). We identified 154 patients with rectal cancer treated by elective laparoscopic AR with anastomosis using primary double-stapling. Clinical variables and comorbidity, habits, and surgery-related variables were assessed by univariate and multivariate analyses to determine preoperative risk factors for clinical AL.

Results

The overall rate of clinical AL was 11.7% (18 of 154 patients), and 5 (27.8%) of 18 patients required revised laparotomy. Data from males were analyzed because AL occurred only in males. Univariate analysis of male patients (n = 100) significantly associated preoperative creatinine values (p = 0.03) and a history of ischemic heart disease (IHD) (p = 0.012) with AL. The frequency of AL tended to increase (p = 0.06) when patients had low AR (p = 0.06) and transanal drainage. Having AL significantly prolonged hospital stays compared with patients without leakage (36.2 vs. 11.1 days; p <  0.01). Multivariate analysis identified a history of IHD (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.27–17.5; p = 0.025] as an independent risk factor for AL.

Conclusions

Male sex and a history of IHD are possible risk factors for AL after elective laparoscopic rectal cancer surgery.
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Metadata
Title
Male sex and history of ischemic heart disease are major risk factors for anastomotic leakage after laparoscopic anterior resection in patients with rectal cancer
Authors
Seiichi Shinji
Yoshibumi Ueda
Takeshi Yamada
Michihiro Koizumi
Yasuyuki Yokoyama
Goro Takahashi
Masahiro Hotta
Takuma Iwai
Keisuke Hara
Kohki Takeda
Mikihiro Okusa
Hayato Kan
Eiji Uchida
Hiroshi Yoshida
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2018
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-018-0846-3

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