Predicting the risk of anastomotic leakage after anterior resection for rectal

doi:10.3877/cma.j.issn.2095-3224.2019.01.007

Abstract

Abstract:

Objective

To evaluate the risk of anastomotic leakage after anterior resection for rectal.

Methods

From March 2005 to August 2009, 338 rectal cancer patients who underwent anterior resection of the Department of General Surgery in the Affiliated Changzheng Hospital of Second Military Medical University were selected as the subjects. All patients experienced a total mesorectal excision operation. Univariate and multivariate analysis were performed to determine risk factors for anastomotic leakage.

Results

The incidence of anastomotic leakage was 9.2%. Univariate analysis and multivariate analysis revealed that age (OR: 3.380, 95%CI: 1.346~8.489), BMI (OR: 11.828, 95%CI: 4.123~33.858), tumor location (OR: 6.304, 95%CI: 162~18.382), and intestinal obstruction (OR: 6.675, 95%CI: 2.164~20.594) were independent factors for anastomotic leakage.

Conclusions

The incidence of anastomotic leakage after anterior resection of rectum was related to the factors such as gender, age, BMI index, tumor location and intestinal obstruction. For patients with risk factors such as men, advanced age, obesity, low rectal cancer, intestinal obstruction, postoperative anastomotic leakage risk will increase.

Key words: Rectal neoplasms, Colorectal surgery, Anastomotic leakage, Total mesorectal excision

Yayun Xie, Yanyan Zhang, Jia Zang, Zhiqian Hu. Predicting the risk of anastomotic leakage after anterior resection for rectal[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(01): 38-41.

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Figures/Tables 3

References 21

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变量		未发生吻合漏组（n=307）	发生吻合口漏组（n=31）	χ²值	P值
年龄（岁）		?	?	12.82	<0.001
?	<65	182	8	?	?
?	≥65	125	23	?	?
性别		?	?	7.367	0.007
?	男性	170	25	?	?
?	女性	137	6	?	?
ASA（分）		?	?	0.785	0.376
?	≤2	271	29	?	?
?	≥3	36	2	?	?
BMI指数（kg/m²）		?	?	26.98	<0.001
?	<27	282	19	?	?
?	≥27	25	12	?	?
肿瘤位置（cm）		?	?	12.336	<0.001
?	<6	32	10	?	?
?	≥6	275	21	?	?
TNM分期		?	?	1.109	0.292
?	Ⅰ~Ⅱ	169	14	?	?
?	Ⅲ	138	17	?	?
高血压		?	?	0.085	0.771
?	有	101	11	?	?
?	无	206	20	?	?
糖尿病		?	?	4.334	0.037
?	有	45	9	?	?
?	无	262	22	?	?
饮酒（两）		?	?	0.231	0.631
?	≤3	211	20	?	?
?	≥4	96	11	?	?

变量		未发生吻合漏组（n=307）	发生吻合口漏组（n=31）	χ²值	P值
年龄（岁）		?	?	12.82	<0.001
?	<65	182	8	?	?
?	≥65	125	23	?	?
性别		?	?	7.367	0.007
?	男性	170	25	?	?
?	女性	137	6	?	?
ASA（分）		?	?	0.785	0.376
?	≤2	271	29	?	?
?	≥3	36	2	?	?
BMI指数（kg/m²）		?	?	26.98	<0.001
?	<27	282	19	?	?
?	≥27	25	12	?	?
肿瘤位置（cm）		?	?	12.336	<0.001
?	<6	32	10	?	?
?	≥6	275	21	?	?
TNM分期		?	?	1.109	0.292
?	Ⅰ~Ⅱ	169	14	?	?
?	Ⅲ	138	17	?	?
高血压		?	?	0.085	0.771
?	有	101	11	?	?
?	无	206	20	?	?
糖尿病		?	?	4.334	0.037
?	有	45	9	?	?
?	无	262	22	?	?
饮酒（两）		?	?	0.231	0.631
?	≤3	211	20	?	?
?	≥4	96	11	?	?

变量		未发生吻合漏组（n=307）	发生吻合口漏组（n=31）	χ²值	P值
肠梗阻		?	?	9.971	0.02
?	否	282	23	?	?
?	是	25	8	?	?
术前血红蛋白（g/L）		?	?	0.839	0.36
?	<90	10	2	?	?
?	≥90	297	29	?	?
术前白蛋白（g/L）		?	?	11.489	0.01
?	<35	18	7	?	?
?	≥35	289	24	?	?
手术时间（min）		?	?	0.632	0.426
?	<150	273	29	?	?
?	≥150	34	2	?	?
腹腔镜手术		?	?	2.033	0.154
?	是	19	0	?	?
?	否	288	31	?	?
术中是否输血		?	?	1.798	0.18
?	是	72	4	?	?
?	否	235	27	?	?

变量		未发生吻合漏组（n=307）	发生吻合口漏组（n=31）	χ²值	P值
肠梗阻		?	?	9.971	0.02
?	否	282	23	?	?
?	是	25	8	?	?
术前血红蛋白（g/L）		?	?	0.839	0.36
?	<90	10	2	?	?
?	≥90	297	29	?	?
术前白蛋白（g/L）		?	?	11.489	0.01
?	<35	18	7	?	?
?	≥35	289	24	?	?
手术时间（min）		?	?	0.632	0.426
?	<150	273	29	?	?
?	≥150	34	2	?	?
腹腔镜手术		?	?	2.033	0.154
?	是	19	0	?	?
?	否	288	31	?	?
术中是否输血		?	?	1.798	0.18
?	是	72	4	?	?
?	否	235	27	?	?

?	B	S.E.	Wald	df	P值	OR值	95% CI
?	B	S.E.	Wald	df	P值	OR值	下限	上限
性别	0.901	0.554	2.646	1	0.104	2.463	0.831	7.297
年龄	1.218	0.470	6.716	1	0.010	3.380	1.346	8.489
DM	0.780	0.517	2.277	1	0.131	2.182	0.792	8.489
BMI	2.471	0.537	21.199	1	0.000	11.828	4.132	33.858
肿瘤位置	1.841	0.546	11.368	1	0.001	6.304	2.162	18.382
是否肠梗阻	1.898	0.575	10.566	1	0.001	6.675	2.164	20.594

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