Premium
A scoring system to predict the risk of anastomotic leakage after anterior resection for rectal cancer
Author(s) -
Liu Yingjun,
Wan Xiangbin,
Wang Gangcheng,
Ren Yingkun,
Cheng Yong,
Zhao Yuzhou,
Han Guangsen
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23467
Subject(s) - medicine , colorectal cancer , logistic regression , univariate analysis , surgery , anastomosis , body mass index , colorectal surgery , anal verge , multivariate analysis , concomitant , cancer , abdominal surgery
Background Various risk factors for anastomotic leakage after anterior resection for rectal cancer have been documented in previous studies. However, there have been no quantized studies to more accurately predict the risk of anastomotic leakage. Methods A total of 1,060 patients with rectal cancer who underwent anterior resection were included in the study. Potential risk factors for leakage including gender, age, body mass index (BMI), diabetes, preoperative radiotherapy, tumor size, level of anastomosis, intraoperative blood loss, concomitant resection of other organs and TNM stage were subjected to univariate analysis. Multivariate logistic regression analysis was used to identify the independent risk factors for anastomotic leakage. The scoring system was developed based on regression coefficient for each significant risk factor. Results Independent risk factors included male gender, low level of anastomosis from anal verge and high‐volume intraoperative blood loss. These patients were separated into high risk, intermediate risk and low risk groups based on scores of 4–5, 2–3, and 0–1. The leakage rates of the three groups were 16.1%, 8.0%, and 1.9%, respectively ( P < 0.001). Conclusions The scoring system is effective and accurate for identifying a subgroup of patients at high risk for leakage. J. Surg. Oncol. 2014 109:122–125 . © 2013 Wiley Periodicals, Inc.