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Risk factors of symptomatic anastomotic leakage and its impacts on a long-term survival after laparoscopic low anterior resection for rectal cancer: a retrospective single-center study

Article scientifique 2021 Anglais

Résumé

BACKGROUND: Postoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer. AL can potentially affect short-term patient outcomes and long-term prognosis. This study aimed to explore the risk factors and long-term survival of symptomatic AL after laparoscopic LAR for rectal cancer. METHODS: From May 2009 to May 2015, 298 consecutive patients who underwent laparoscopic LAR for rectal cancer with or without a defunctioning stoma were included in this study. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for symptomatic AL. Survival analysis was performed using Kaplan-Meier curves, and log-rank tests were used for group comparisons. RESULTS: Among the 298 patients enrolled in this study, symptomatic AL occurred in eight (2.7%) patients. The univariate analysis showed that age of ≤65 years (P = 0.048), neoadjuvant therapy (P = 0.095), distance from the anal verge (P = 0.078), duration of operation (P = 0.001), and pathological tumor (T) category (P = 0.004) were associated with symptomatic AL. The multivariate analysis demonstrated that prolonged duration of operation (P = 0.010) was an independent risk factor for symptomatic AL after laparoscopic LAR for rectal cancer. No statistically significant differences were observed in the 3-year (P = 0.785) and 5-year (P = 0.979) overall survival rates. CONCLUSIONS: A prolonged duration of operation increased the risk of symptomatic AL after laparoscopic LAR for rectal cancer. An impact of symptomatic AL on a long-term survival was not observed in this study; however, further studies are required. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry ( ChiCTR2000033413 ) on May 31, 2020.

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Qi, X., Liu, M., Xu, K., Gao, P., Tan, F., Yao, Z., Zhang, N., Yang, H., Zhang, C., Xing, J., Cui, M., Su, X. (2021). Risk factors of symptomatic anastomotic leakage and its impacts on a long-term survival after laparoscopic low anterior resection for rectal cancer: a retrospective single-center study. https://doi.org/10.1186/s12957-021-02303-5

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Xinyu Qi Maoxing Liu Kai Xu Pin Gao Fei Tan Zhendan Yao Nan Zhang Hong Yang Chenghai Zhang Jiadi Xing Ming Cui Xiangqian Su

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