From the Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
From the Department of Pediatric Surgery, King Abdullah Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Ann Saudi Med. 2024 May-Jun;44(3):135-140. doi: 10.5144/0256-4947.2024.135. Epub 2024 Jun 6.
Anastomotic leakage (AL) represents a severe complication after rectal surgery, leading to significant morbidity, mortality, and increased healthcare costs. Despite improvements in surgical methods and perioperative care, the challenge of AL persists.
Explore the impact of body mass index (BMI) on the risk of AL following curative treatment for rectal cancer, providing insight into its predictive value.
Retrospective review.
Data were collected from a single tertiary center, emphasizing the specialized postoperative outcomes in a high-care setting.
The study population was comprised patients who underwent sphincter-saving surgery combined with neoadjuvant chemoradiation for rectal cancer from 2001 to 2011. Patients with anastomotic stenosis were excluded.
The primary outcome investigated was the occurrence of AL post-surgery. Secondary outcomes included the assessment of local cancer recurrence rates within the AL group.
224; 13 excluded.
Of 237 patients who underwent surgery, 13 with anastomotic stenosis were excluded from this study. Of the remaining 224, 15 individuals (6.3%) developed AL. A potential association between higher BMI and increased AL risk was identified. Additionally, the study noted a higher incidence of local rectal cancer recurrence in the group that developed leakage.
The findings suggest BMI as a significant predictive factor for AL after curative rectal cancer treatment. This emphasizes the need for heightened awareness and possible preoperative counseling for obese patients regarding their increased risk of postoperative leakage.
The study was retrospective with all the inherit biases of such studies. The sample size was small and this may have introduced a type 2 statistical error.
吻合口漏（AL）是直肠手术后的一种严重并发症，可导致严重的发病率、死亡率增加和医疗费用增加。尽管手术方法和围手术期护理有所改善，但吻合口漏的问题仍然存在。
探讨体质量指数（BMI）对直肠癌根治性治疗后吻合口漏风险的影响，了解其预测价值。
回顾性研究。
数据来自于一家单中心，强调了高护理环境下的术后特殊结局。
研究人群为 2001 年至 2011 年间接受保肛手术联合新辅助放化疗治疗的直肠癌患者。排除吻合口狭窄的患者。
主要观察指标是术后吻合口漏的发生。次要观察指标包括吻合口漏组局部癌症复发率的评估。
224；排除 13 例。
在 237 例接受手术的患者中，有 13 例因吻合口狭窄被排除在本研究之外。在剩余的 224 例患者中，有 15 例（6.3%）发生了 AL。研究发现，BMI 较高与 AL 风险增加之间存在潜在关联。此外，研究还注意到在发生渗漏的组中局部直肠癌症复发的发生率更高。
研究结果表明，BMI 是直肠癌根治性治疗后 AL 的一个重要预测因素。这强调了对肥胖患者在术后渗漏风险增加方面进行术前咨询的必要性。
本研究为回顾性研究，存在此类研究固有的所有偏倚。样本量较小，可能会引入第二类统计误差。
