Objective: Anastomotic Leakage (AL) is one of the most common complications after resection of rectal cancer. Recognition of the incidence and risk factors related to AL is important. This study aimed develops a model that can predict anastomotic leakage after anterior rectal resection.
Methods: Data from 188 patients undergoing anterior resection of rectal cancer were collected for retrospective analysis. Patients were randomly divided in the development set and validation set at a 1:1 ratio. We first included age, sex, preoperative chemoradiotherapy, tumor size, degree of tumor differentiation, stage, TNM stage, lymph vascular invasion, distance, anastomotic method, diabetes, intraoperative time, intraoperative bleeding and smoking as candidates for variable selection with a LASSO method. A ROC curve was constructed with the validation set to assess the accuracy of the prediction model.
Results: AL occurred in 20 of 188 patients (10.6%). Preoperative chemoradiotherapy (p=0.04), medium degree of tumor differentiation (p=0.04), anastomotic method (p<0.01), intraoperative bleeding≥400ml (p<0.01), smoking (p<0.01), diabetes (p<0.01) were significantly related to AL. The area under the ROC curve of the prediction model is 0.952.
Conclusions: This study developed a model that can predict anastomotic leakage after anterior rectal resection, which may aid the selection of preventive ileostomy and postoperative management.
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http://dx.doi.org/10.12669/pjms.35.3.252 | DOI Listing |
Asian Pac J Cancer Prev
January 2025
Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Objective: This study aimed to clarify whether nutritional status at admission affects enteral nutrition weaning 6 months after surgery in patients with esophageal cancer.
Methods: This was a retrospective study of 81 patients who underwent subtotal esophageal cancer resection between April 2014 and February 2016. The survey items were as follows: 1) sex, 2) age, 3) presence or absence of family members living together, 4) clinical stage, 5) surgical procedure, 6) reconstructed organs, 7) nutritional status at admission, 8) presence or absence of postoperative complications (anastomotic leakage, chylothorax, and recurrent laryngeal nerve paralysis), and 9) presence or absence of treatment other than surgery (chemo- or radiotherapy).
World J Gastrointest Surg
January 2025
Department of Minimally Invasive Digestive Surgery, Antoine-Béclère Hospital, Assistance Publique-Hôpitaux de ParisClamart 92140, Haute-Seine, France.
Anastomotic leakage (AL) is a significant complication following rectal cancer surgery, adversely affecting both quality of life and oncological outcomes. Recent advancements in artificial intelligence (AI), particularly machine learning and deep learning, offer promising avenues for predicting and preventing AL. These technologies can analyze extensive clinical datasets to identify preoperative and perioperative risk factors such as malnutrition, body composition, and radiological features.
View Article and Find Full Text PDFTher Adv Urol
January 2025
Division of Urology, University of Colorado Denver, Aurora, CO, USA.
Urinary diversions are performed for a wide variety of indications, including bladder removal for cancer treatment, post-cancer treatment complications, trauma, or bladder pain. The robotic approach has been increasingly used in performing urinary diversions since the introduction of the surgical robot. A PubMed keyword search was performed on September 14, 2023 with the terms: robotic and urinary diversion.
View Article and Find Full Text PDFSurg Endosc
January 2025
Clinica Chirurgica, Department of Experimental and Clinical Medicine, Section of Surgical Sciences, Polytechnic University of Marche, Ancona, Italy.
Introduction: Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI).
View Article and Find Full Text PDFAims: With the recently validated tool for estimating chronic pain after colorectal cancer surgery, the aims of this study were to calculate the prevalence and to identify predictive risk factors for chronic pain after colorectal cancer treatment.
Method: Clinical data from colorectal cancer patients treated between 2001 and 2014 were obtained from the Danish Colorectal Cancer Group database. In 2016, all survivors were invited to participate in a national cross-sectional questionnaire study on long-term functional outcomes, including the chronic pain questionnaire.
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