Notash Aidin Yaghoobi, Sadeghian Ehsan, Moghimi Zahra, Rahimi Yasaman, Sobhanian Ehsan
General Surgeon and Faculty Member, Tehran University of Medical Sciences, Tehran, Iran.
Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2025 Jul 1;15(1):20950. doi: 10.1038/s41598-025-06712-4.
Anastomotic leakage (AL) is one of the most serious complications following colorectal surgery, particularly in patients who have undergone low anterior resection (LAR) for rectal cancer without a protective ileostomy. The early detection of AL is crucial, as it can significantly impact the patient's recovery and survival rates. This study aims to assess the diagnostic accuracy of abdominal Computed Tomography(CT) scans in identifying AL among rectal cancer patients post-LAR. This retrospective cohort study was conducted at the Tehran Surgical Research Center and included 42 patients with rectal cancer who underwent LAR after neoadjuvant chemoradiotherapy. All patients received an abdominal CT scan on the fifth postoperative day. The presence of AL was confirmed based on clinical symptoms, radiological findings, and the necessity for reoperation. The study focused on evaluating specific CT findings, such as perianastomotic collections, to determine their correlation with AL. The analysis revealed that certain CT scan findings, particularly complex collections larger than 5 cm in proximity to the anastomosis site and signs of generalized peritonitis, were significantly associated with the presence of AL. These findings were particularly important in cases where patients also exhibited clinical symptoms like fever and leukocytosis. The presence of these CT indicators often necessitated reoperation to address the leakage. The results of this study suggest that while abdominal CT scans are a valuable tool in the early detection of AL, the interpretation of these scans must be done in conjunction with clinical symptoms. The study highlights the importance of considering the size of perianastomotic collections and the presence of systemic symptoms for an accurate and timely diagnosis of AL. Future research should further investigate the potential of CT scans in improving outcomes for patients undergoing LAR for rectal cancer.
吻合口漏（AL）是结直肠手术后最严重的并发症之一，尤其是在未行保护性回肠造口术而接受直肠癌低位前切除术（LAR）的患者中。早期发现AL至关重要，因为它会显著影响患者的恢复和生存率。本研究旨在评估腹部计算机断层扫描（CT）在识别LAR术后直肠癌患者中AL的诊断准确性。这项回顾性队列研究在德黑兰外科研究中心进行，纳入了42例在新辅助放化疗后接受LAR的直肠癌患者。所有患者在术后第5天接受腹部CT扫描。根据临床症状、影像学表现和再次手术的必要性来确认AL的存在。该研究重点评估特定的CT表现，如吻合口周围积液，以确定它们与AL的相关性。分析显示，某些CT扫描表现，特别是吻合口部位附近大于5 cm的复杂积液以及弥漫性腹膜炎体征，与AL的存在显著相关。在患者还表现出发热和白细胞增多等临床症状的情况下，这些发现尤为重要。这些CT指标的存在往往需要再次手术来处理渗漏。本研究结果表明，虽然腹部CT扫描是早期发现AL的有价值工具，但这些扫描结果的解读必须结合临床症状。该研究强调了考虑吻合口周围积液大小和全身症状的存在对于准确及时诊断AL的重要性。未来的研究应进一步探讨CT扫描在改善直肠癌LAR患者预后方面的潜力。
