Clinical characteristics and risk factors for anastomotic leakage after laparoscopic rectal cancer surgery in the setting of neoadjuvant therapy
- VernacularTitle:新辅助放化疗直肠癌术后吻合口漏的临床特征及危险因素分析
- Author:
Ganbin LI
1
;
Xiao ZHANG
1
;
Xiaoyuan QIU
1
;
Chentong WANG
1
;
Weijie CHEN
1
;
Guannan ZHANG
1
;
Beizhan NIU
1
;
Lai XU
1
;
Junyang LU
1
;
Bin WU
1
;
Yi XIAO
1
;
Guole LIN
1
Author Information
- Publication Type:Journal Article
- Keywords: Rectal neoplasms; Anastomotic leak; Colostomy; Proctectomy; Risk factors
- From: Chinese Journal of General Surgery 2025;40(2):108-113
- CountryChina
- Language:Chinese
- Abstract: Objective:To evaluate the clinical features and risk factors of anastomotic leakage (AL) in patients with locally advanced rectal cancer (LARC) receiving neoadjuvant chemoradiotherapy (nCRT) followed by laparoscopic radical resection and proctocol ostomy.Method:Clinicla data of LARC patients receiving neoadjuvant chemoradiotherapy followed by laparoscopic radical resection and proctocol ostomy admitted to Peking Union Medical College Hospital between Jan 2019 and Oct 2023 was enrolled. According to the occurrence of AL, patients were divided into AL group and non-AL group.Results:After propersity matching score(PSM), there were 40 patients (33.4%) and 80 patients (66.6%) in the AL and non-AL group, respectively. The first-onset symptoms of AL were abnormal character and color of the drainage (23 cases, 57.5%) and fever (14 cases, 35.0%). About 82.5% of the AL were graded as B,and all 36 patients (90.0%) were managed consveratively by fully drainage anti-infection therapy. Logistic regression analysis indicated that tumor circumferential range more than 1/2 cycle ( OR=5.95, 95% CI:2.12-1.67, P=0.004), male ( OR=4.28, 95% CI:1.22-15.00, P=0.023) and high-ligation of Inferior mesenteric artery ( OR=8.08, 95% CI:1.86-37.78, P=0.006) were independent risk factors of AL. Conclusions:In this series, grade-B AL ranks the top of the incidence, and all were cured by conservative therapy. Special attention should be paid to those patients with the characteristics of male, tumor circumferential range more than 1/2 cycle, and high-ligation of inferior mesenteric artery.
