Early predictive factors and risk assessment for anastomotic leakage in patients undergoing low anterior resection for rectal cancer

H. Ozgul, U. Dogan, R.C. Cakir, Y. Uzmay, C.O. Ensari, O. Celik, T.T. Kaplan, A. Aslaner

Department of General Surgery, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey. halit.ozgul1@saglik.gov.tr

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• Oncology

OBJECTIVE: Anastomotic leakage is a complication that creates significant concern in terms of postoperative morbidity and mortality after colorectal surgery. This study aimed to identify variables for detecting anastomotic leakage in those who had open, laparoscopic, or robotic low anterior resection for cancer and to explore their relationships.

PATIENTS AND METHODS: A total of 283 patients who were diagnosed with rectal cancer and underwent low anterior resection were divided into two groups: those with and without anastomotic leakage. Demographic and clinical data were analyzed. Anastomotic leakage was detected in 23 of 283 patients who underwent low anterior resection.

RESULTS: The postoperative analysis of the biochemical data of the patients showed statistically significant differences between the two groups in terms of C-reactive protein (Crp), albumin, lymphocytes, leukocytes, neutrophils, and their ratio. The performance of these parameters in predicting anastomotic leakage was statistically analyzed in the patient group with anastomotic leakage, and nomogram results were acquired. Immune system components and biomarkers were statistically tested, and nomogram results were obtained in rectal cancer patients.

CONCLUSIONS: These parameters can be used together as a potential marker in anastomotic leakage. Further development of these variables has the potential to facilitate the timely detection and treatment of anastomotic leakage.

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