Predictive Factors of Anastomotic Leakage after Resection of Left Colon Cancer: A Single Center Experience

Q4 Medicine
A. Shehta, Ahmed Farouk, M. Elashry, Ibrahim L. Abulazm, Mohamed M. El-Sorogy, A. Monier
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Abstract

Purpose: To evaluate the incidence and the different potential risk factors for the development of anastomotic leakage (AL) after resection of left-sided colon cancer. Also, to evaluate the AL impact on long-term survival outcomes. Methods: We reviewed the cases who underwent surgical resection of left-sided colon cancer during the period between January 2008 and December 2018. Results: 218 cases were included in our study. The commonest presentations were weight loss (45.9%), and bleeding per rectum (40.8%). Left hemi-colectomy was performed in 101 cases (46.3%) and sigmoidectomy in 117 cases (53.7%). The median operation time was 3 hours (1 – 5), and blood loss was 150 ml (50 – 750). Postoperative morbidity occurred in 28 cases (22.1%). AL occurred in 12 cases (5.5%). Early mortality occurred in 6 cases (2.8%). After median follow up of 38 months (15 – 120), mortality occurred in 44 cases (20.2%). The 1, 3-, and 5-years overall survival (OS) were 98.8%, 84.4%, and 64.4%, respectively. Recurrence occurred in 91 cases (41.7%). The 1, 3-, and 5-years disease-free survival (DFS) were 94.9%, 49.1%, and 38%, respectively. We did not find any significant differences between cases with and without AL in terms of OS (p = 0.634) and DFS (p = 0.682). On multivariate analysis, only preoperative serum CEA and operative blood loss were significant predictors for AL. Conclusion: Preoperative serum CEA and operative blood loss were significant predictors for AL. AL did not have a significant impact on the survival outcomes of those cases.
左结肠癌术后吻合口漏的预测因素:单中心经验
目的:探讨左侧结肠癌术后吻合口瘘的发生率及不同的潜在危险因素。同时,评估AL对长期生存结果的影响。方法:回顾2008年1月至2018年12月期间接受左侧结肠癌手术切除的病例。结果:218例病例纳入本研究。最常见的表现是体重减轻(45.9%)和直肠出血(40.8%)。左侧半结肠切除术101例(46.3%),乙状结肠切除术117例(53.7%)。手术中位时间3小时(1 ~ 5),出血量150 ml(50 ~ 750)。术后发病率28例(22.1%)。AL发生12例(5.5%)。早期死亡6例(2.8%)。中位随访38个月(15 - 120),死亡44例(20.2%)。1年、3年和5年总生存率(OS)分别为98.8%、84.4%和64.4%。复发91例(41.7%)。1年、3年和5年无病生存率(DFS)分别为94.9%、49.1%和38%。我们没有发现有AL和没有AL的病例在OS (p = 0.634)和DFS (p = 0.682)方面有任何显著差异。在多因素分析中,只有术前血清CEA和术中出血量是AL的显著预测因子。结论:术前血清CEA和术中出血量是AL的显著预测因子,AL对这些病例的生存结局无显著影响。
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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