Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique
Objectives: Anastomotic leakage (AL) is a serious complication associated with morbidity, mortality, and poor prognosis. This study aimed to identify the risk factors and predictive biomarkers for AL after colorectal surgery with double stapling technique (DST) anastomosis. Methods: We retrospective...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2023-07-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/7/3/7_2022-072/_pdf/-char/en |
| _version_ | 1797773297738317824 |
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| author | Noriyuki Isohata Shungo Endo Tetsutaro Nemoto Daiki Nemoto Masato Aizawa Kenichi Utano Kazutomo Togashi |
| author_facet | Noriyuki Isohata Shungo Endo Tetsutaro Nemoto Daiki Nemoto Masato Aizawa Kenichi Utano Kazutomo Togashi |
| author_sort | Noriyuki Isohata |
| collection | DOAJ |
| description | Objectives: Anastomotic leakage (AL) is a serious complication associated with morbidity, mortality, and poor prognosis. This study aimed to identify the risk factors and predictive biomarkers for AL after colorectal surgery with double stapling technique (DST) anastomosis.
Methods: We retrospectively analyzed 331 patients who underwent elective colorectal cancer surgery with DST anastomosis between April 2012 and July 2021. Patient-, tumor-, and surgery-related variables were examined using univariate and multivariate analyses to identify the risk factors for AL. Postoperative inflammatory biomarkers were also analyzed to identify the predictive factors for AL.
Results: AL occurred in 28 (8.5%) patients. In multivariate analysis, male sex, a history of diabetes mellitus and high ligation of inferior mesenteric artery (IMA) were significant risk factors for AL. Serum C-reactive protein (CRP) levels on postoperative day (POD) 3 and 7 were significantly correlated with AL (OR; 95% CI, 1.134; 1.044-1.232, p = 0.003, and 1.154; 1.036-1.286, p = 0.009, respectively). The cut-off value of CRP on POD 3 was 10.91 mg/dL (sensitivity 0.714, specificity 0.835, positive predictive value [PPV] 0.290, and negative predictive value [NPV] 0.969). The cut-off value of CRP on POD 7 was 4.58 mg/dL (sensitivity 0.821, specificity 0.872, PPV 0.377, and NPV 0.981).
Conclusions: Male sex, a history of diabetes mellitus and high ligation of IMA were risk factors for AL in colorectal cancer surgery with DST anastomosis. The predictive biomarkers for cases without AL were CRP levels on POD 3 and 7. |
| first_indexed | 2024-03-12T22:03:24Z |
| format | Article |
| id | doaj.art-acd4a564b0d345acb96cfecb045d386e |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-03-12T22:03:24Z |
| publishDate | 2023-07-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-acd4a564b0d345acb96cfecb045d386e2023-07-25T02:32:48ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532023-07-017319620510.23922/jarc.2022-0722022-072Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling TechniqueNoriyuki Isohata0Shungo Endo1Tetsutaro Nemoto2Daiki Nemoto3Masato Aizawa4Kenichi Utano5Kazutomo Togashi6Department of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityDepartment of Coloproctology, Aizu Medical Center, Fukushima Medical UniversityObjectives: Anastomotic leakage (AL) is a serious complication associated with morbidity, mortality, and poor prognosis. This study aimed to identify the risk factors and predictive biomarkers for AL after colorectal surgery with double stapling technique (DST) anastomosis. Methods: We retrospectively analyzed 331 patients who underwent elective colorectal cancer surgery with DST anastomosis between April 2012 and July 2021. Patient-, tumor-, and surgery-related variables were examined using univariate and multivariate analyses to identify the risk factors for AL. Postoperative inflammatory biomarkers were also analyzed to identify the predictive factors for AL. Results: AL occurred in 28 (8.5%) patients. In multivariate analysis, male sex, a history of diabetes mellitus and high ligation of inferior mesenteric artery (IMA) were significant risk factors for AL. Serum C-reactive protein (CRP) levels on postoperative day (POD) 3 and 7 were significantly correlated with AL (OR; 95% CI, 1.134; 1.044-1.232, p = 0.003, and 1.154; 1.036-1.286, p = 0.009, respectively). The cut-off value of CRP on POD 3 was 10.91 mg/dL (sensitivity 0.714, specificity 0.835, positive predictive value [PPV] 0.290, and negative predictive value [NPV] 0.969). The cut-off value of CRP on POD 7 was 4.58 mg/dL (sensitivity 0.821, specificity 0.872, PPV 0.377, and NPV 0.981). Conclusions: Male sex, a history of diabetes mellitus and high ligation of IMA were risk factors for AL in colorectal cancer surgery with DST anastomosis. The predictive biomarkers for cases without AL were CRP levels on POD 3 and 7.https://www.jstage.jst.go.jp/article/jarc/7/3/7_2022-072/_pdf/-char/enanastomotic leakagecolorectal cancerdouble stapling technique |
| spellingShingle | Noriyuki Isohata Shungo Endo Tetsutaro Nemoto Daiki Nemoto Masato Aizawa Kenichi Utano Kazutomo Togashi Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique Journal of the Anus, Rectum and Colon anastomotic leakage colorectal cancer double stapling technique |
| title | Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique |
| title_full | Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique |
| title_fullStr | Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique |
| title_full_unstemmed | Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique |
| title_short | Risk Factors and Predictive Biomarkers for Anastomotic Leakage after Colorectal Cancer Surgery with the Double Stapling Technique |
| title_sort | risk factors and predictive biomarkers for anastomotic leakage after colorectal cancer surgery with the double stapling technique |
| topic | anastomotic leakage colorectal cancer double stapling technique |
| url | https://www.jstage.jst.go.jp/article/jarc/7/3/7_2022-072/_pdf/-char/en |
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