medigraphic.com
SPANISH

Cirugía y Cirujanos

  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2019, Number 3

<< Back Next >>

Cir Cir 2019; 87 (3)

Risk factors of anastomotic leakage in colon cancer

González-Valverde FM, Vicente-Ruiz M, Gómez-Ramos MJ
Full text How to cite this article

Language: Spanish
References: 20
Page: 347-352
PDF size: 148.23 Kb.


Key words:

Anastomotic leakage, Colon cancer, Predictive equation, Risk factors.

ABSTRACT

Objective: To analyze the risk factors for anastomosis leak in colon cancer surgery (CCS) in our environment, and developed a predictive equation for that risk. Method: We performed a case-control study nested in a cohort of 576 consecutive patients undergoing colon cancer surgery with primary anastomosis, univariate statistical tests and univariate logistic regression for statistical analysis of associated factors with anastomosis leak in colon cancer surgery, and multivariate logistic regression for predicting that risk using a predictive equation associated with a ROC curve. Results: We obtained a higher risk of anastomosis leak in patients whose operative time was longer than 180 minutes. The variables: preoperative transfusion, previous pathologies, nutritional status, approach, surgical technique or age do not influence the development of this complication. The equation found has a sensitivity of 64.1% and a specificity of 67.5%. Conclusion: Operation time longer than 180 minutes was the main risk factor for anastomosis leak. Our equation can hardly predict this risk. After further validation, our results may help the surgeon make a more individualized, safer decision regarding whether to perform an anastomosis or make a stoma.


REFERENCES

  1. Leichtle SW, Mouawad NJ, Welch KB, Lampman RM, Cleary RK. Risk factors for anastomotic leakage after colectomy. Dis Colon Rectum. 2012;55:569-75.

  2. Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K. Association Française de Chirurgie. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Arch Surg. 2005;140:278-83.

  3. Telem D, Chin E, Nguyen S, Divino C. Risk factors for anastomotic leak following colorrectal surgery. Arch Surg. 2010;145:371-6.

  4. Midura EF, Hanseman D, Davis BR, Atkinson SJ, Abbott DE, Shah SA, et al. Risk factors and consequences of anastomotic leak after colectomy: a national analysis. Dis Colon Rectum. 2015;58:333-8.

  5. Piecuch J, Wiewiora M, Jopek J, Szrot M, Mazur I, Zurawinski W, et al. Mortality and anastomotic leakage after anterior resection for rectal cancer. Hepatogastroenterology. 2012;59:721-3.

  6. Sobin H, Wittekind CH. TNM Classification of malignant tumours. International Union Against Cancer. New York: John Wiley and Sons; 2002.

  7. Neutzling CB, Lustosa SA, Proenca IM, da Silva EM, Matos D. Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev. 2012;(2):CD003144.

  8. Dunne JR, Malone D, Tracy JK, Gannon C, Napolitano LM. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res. 2002;102:237-44.

  9. Suding P, Jensen E, Abramson MA, Itani K, Wilson SE. Definitive risk factors for anastomotic leaks in elective open colorectal resection. Arch Surg. 2008;143:907-11.

  10. Wu WC, Schifftner TL, Henderson WG. Preoperative hematocrit levels and postoperative outcomes in older patients undergoing noncardiac surgery. JAMA. 2007;297:2481-8.

  11. Parker MC. Epidemiology of adhesions: the burden. Hosp Med. 2004; 65:330-6.

  12. Kirchhoff P, Clavien PA, Hahnloser D. Complications in colorectal surgery: risk factors and preventive strategies. Patient Saf Surg. 2010;4 5.

  13. Mäkelä JT, Kiviniemi H, Laitinen S. Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis. Dis Colon Rectum. 2003;46 653-60.

  14. Lai R, LuY, Li Q, Guo J, Chen G, Zeng W. Risk factors for anastomotic leakage following anterior resection for colorectal cancer: the effect of epidural analgesia on occurrence. Int J Colorectal Dis. 2013;28:485-92.

  15. Vignali A, Fazio VW, Lavery IC, Milson JW, Church JM, Hull TL, et al. Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1014 patients. J Am Coll Surg. 1997;185:105-13.

  16. Cong ZJ, Fu CG, Yu ED, Liu LJ, Zhang W, Meng RG, et al. Factors associated with anastomotic leakage after anterior resection in rectal cancer. Zhonghua Wai Ke Za Zhi. 2009;47:594-8.

  17. Pakkastie T, Luukkonen P, Jarvinen J. Anastomotic leakage after anterior resection of the rectum. Eur J Surg. 1994;160:293-7.

  18. Groene SA, Chandrasekera CV, Prasad T, Lincourt AE, Todd Heniford B, Augenstein VA. Right versus left-sided colectomies: a comparison of outcomes. Am Surg. 2016;82 580-7.

  19. Breukink S, Pierie J, Wiggers T. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2006;(4):CD005200.

  20. Schwenk W, Haase O, Neudecker J, Müller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev. 2005; (3):CD003145.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Cir Cir. 2019;87