Rodriguez Sergio Luis Ramos, Montoro David Francisco Stein, De la Cruz Ku Gabriel, Del Rocio Luna Munoz Consuelo, Bustamante Cesar Ramon Razuri
Universidad Ricardo Palma, Lima 15033, Peru.
Universidad Cientifica del Sur, Lima 15067, Peru.
Ecancermedicalscience. 2024 Apr 16;18:1696. doi: 10.3332/ecancer.2024.1696. eCollection 2024.
The anastomotic leak (AL) is one of the most feared complications of colorectal surgery, since it is associated with a high rate of morbidity, mortality, length of hospital stay and cost of care. Our aim was to determine the risk factors associated with anastomosis leak in colorectal cancer patients who underwent surgical resection with anastomosis.
A multicentre observational, analytical, retrospective and case-control study was carried out. For each case, two controls were included from three national hospitals from Lima, Peru during the period 2021-2022. To determine the degree of association, multivariate logistic regression model was carried out.
A total of 360 patients were included, 120 from each hospital. The mean age of the population was 68.03 ± 14.21 years old. The majority were 65 years old or older (66.1%), 52.8% were female, and 63.3% had clinical stage III. The 40% of the patients had albumin levels lower than 3.5 g/dL. Regarding the surgery, 96.4% were elective, 68.9% underwent open approach, and 80.8% had an operative time of more than 180 minutes. Most of them had right colon cancer (50.8%). In the multivariate analysis, a significant association was found with the age variable (OR = 2.48; 95%CI:1.24-4.97), clinical tumour level (OR = 2.71; 95%CI:1.34-5.48), American Society of Anesthesiologists (ASA) Score (OR = 3.23; 95%CI:1.10-9.50), preoperative serum albumin (OR = 22.2; 95%CI:11.5-42.9).
The most important independent risk factors associated with AL among patients with colorectal cancer were pre-operative such as lower preoperative serum albumin levels, followed by a higher ASA Score, clinical-stage III-IV, and an age ≥65 years old.
吻合口漏（AL）是结直肠手术中最令人担忧的并发症之一，因为它与高发病率、死亡率、住院时间和护理成本相关。我们的目的是确定接受吻合术的结直肠癌患者中与吻合口漏相关的危险因素。
进行了一项多中心观察性、分析性、回顾性病例对照研究。在2021年至2022年期间，从秘鲁利马的三家国立医院为每个病例纳入两名对照。为确定关联程度，进行了多变量逻辑回归模型分析。
共纳入360例患者，每家医院120例。总体平均年龄为68.03±14.21岁。大多数患者年龄在65岁及以上（66.1%），52.8%为女性，63.3%处于临床III期。40%的患者白蛋白水平低于3.5g/dL。关于手术，96.4%为择期手术，68.9%采用开放手术方式，80.8%的手术时间超过180分钟。大多数患者患有右结肠癌（50.8%）。在多变量分析中，发现与年龄变量（OR=2.48；95%CI：1.24-4.97）、临床肿瘤分期（OR=2.71；95%CI：1.34-5.48）、美国麻醉医师协会（ASA）评分（OR=3.23；95%CI：1.10-9.50）、术前血清白蛋白（OR=22.2；95%CI：11.5-42.9）存在显著关联。
结直肠癌患者中与吻合口漏相关的最重要独立危险因素是术前因素，如术前血清白蛋白水平较低，其次是较高的ASA评分、临床III-IV期以及年龄≥65岁。
