scholarly journals Impact of Early Postoperative Diarrhea on Anastomotic Leakage after Laparoscopic Low Anterior Resection for Rectal Cancer

2020 ◽  
Vol 45 (4) ◽  
pp. 295-300
Author(s):  
Hiroyuki Ohta ◽  
Toru Miyake ◽  
Tomoyuki Ueki ◽  
Masatsugu Kojima ◽  
Eiji Mekata ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Laparoscopic Low Anterior Resection

scholarly journals Risk and early predictive factors of anastomotic leakage in laparoscopic low anterior resection for rectal cancer

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Masahiro Fukada ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Hisashi Imai ◽  
Yoshihiro Tanaka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Blood Loss ◽  
Anastomotic Leakage ◽  
Predictive Factors ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Univariate Analysis ◽  
Intraoperative Blood Loss ◽  
Laparoscopic Low Anterior Resection

Abstract Background In recent years, laparoscopic surgery has been widely used for rectal cancer. In laparoscopic rectal surgery, a double-stapling technique (DST) anastomosis using a stapling device is considered a relatively difficult procedure. Postoperative anastomotic leakage (AL) is a major complication related to patients’ quality of life and prognosis. Methods This study was a retrospective, single-institution study of 101 rectal cancer patients who underwent laparoscopic low anterior resection (LAR) with DST anastomosis (excluding simultaneous resection of other organs and construction of protective diverting stoma) between February 2008 and November 2017 at the Gifu University Graduate School of Medicine. This study aimed to identify risk and early predictive factors of AL. Results Among 101 patients, symptomatic AL occurred in 13 patients (12.9%), of whom 10 were male and 3 were female. Their median BMI was 22.7 kg/m2 (range, 17.9–26.4 kg/m2). Among the pre- and intraoperative factors, AL was significantly associated with tumor location (lower rectum), distance from the anal verge (< 6 cm), intraoperative blood loss (≥ 50 ml), and the number of linear staples (≥ 2) in univariate analysis. In multivariate analysis, only intraoperative blood loss (≥ 50 ml, odds ratio [OR] 4.59; 95% confidence interval [CI] 1.04–19.52; p = 0.045) was identified as an independent risk factor for AL. Among the postoperative factors, AL was significantly associated with tachycardia-POD1 (≥ 100 bpm), CRP-POD3 (≥ 15 mg/dl), fever on postoperative day (fever-POD) 3 (≥ 38 °C), and first defecation day after surgery (< POD3) in univariate analysis. In multivariate analysis, fever-POD3 (≥ 38 °C, OR 30.97; 95% CI 4.68–311.22; p = 0.0003) and first defecation day after surgery (< POD3, OR 5.82; 95% CI 1.34–31.30; p = 0.019) were identified as early predictive factors for AL. Conclusion In this study, intraoperative blood loss was an indicator of difficulty in a transection and anastomosing procedure, and fever-POD3 and early first defecation day after surgery were independent early predictive factors for AL. Careful surgery using an appropriate technique and standardized procedures with minimal bleeding and careful postoperative management paying attention to fever and defecation may prevent the onset and severity of AL.

scholarly journals Laparoscopic low anterior resection for rectal cancer with rectal prolapse: a case report

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
Ryusei Yamamoto ◽  
Yasuji Mokuno ◽  
Hideo Matsubara ◽  
Hirokazu Kaneko ◽  
Shinsuke Iyomasa
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Rectal Prolapse ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Laparoscopic Low Anterior Resection
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