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1Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
2Department of Surgery I, University Hospital Olomouc, Olomouc, Czech Republic
Copyright © 2023 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
FUNDING
This study was supported by Ministry of Health, Czech Republic; conceptual development of research organization (FNOl, 00098892).
AUTHOR CONTRIBUTIONS
Conceptualization: TR, PZ, DK; Data curation: TR, PS, MS; Formal analysis: all authors; Visualization: TR, PZ, RV; Writing–original draft: TR, RV; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Variable |
Leak |
P-valuea | ||
---|---|---|---|---|
0 | 1 | |||
BMI > 30 kg/m2 | 0 | 112 (77.8) | 4 (57.1) | 0.354 |
1 | 32 (22.2) | 3 (42.9) | ||
Rectal tumor, 5–17 cm | 0 | 102 (70.8) | 3 (42.9) | 0.201 |
1 | 42 (29.2) | 4 (57.1) | ||
Radiotherapy | 0 | 135 (93.8) | 7 (100) | > 0.999 |
1 | 9 (6.3) | 0 (0) | ||
Stage of tumor disease | 0 | 2 (1.4) | 0 (0) | 0.427 |
I | 35 (24.3) | 4 (57.1) | ||
II | 48 (33.3) | 2 (28.6) | ||
III | 49 (34.0) | 1 (14.3) | ||
IV | 10 (7.0) | 0 (0) | ||
Laparoscopic surgery | 0 | 102 (70.8) | 4 (57.1) | 0.426 |
1 | 42 (29.2) | 3 (42.9) | ||
Open surgery | 0 | 39 (27.1) | 3 (42.9) | 0.398 |
1 | 105 (72.9) | 4 (57.1) | ||
Median value | ||||
Age (yr) | 67.5 | 60.0 | 0.087 | |
Weight (kg) | 79.0 | 75.0 | 0.710 | |
BMI (kg/m2) | 26.5 | 26.0 | 0.743 | |
Tumor distance (cm) | 20.0 | 15.0 | 0.188 |
Patient No. |
Risk factor |
|||||||||
---|---|---|---|---|---|---|---|---|---|---|
Sex | NS TP/Alb (g/L) | Steroids use | IBD | DMa | NSAIDs use | RT | No. of staples fired | Type of anastomose | Type of leak | |
1 | Female | 54.4/32.8 | 0 | 0 | 0 | 0 | 0 | 2 | End to end | A |
2 | Female | 48.6/27.7 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | A |
3 | Male | 41.8/20 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | A |
4 | Male | 49.6/25.4 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | B |
5 | Male | 40.9/17.5 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | B |
6 | Male | 47.4/39.4 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | C |
7 | Male | 41.2/18 | 0 | 0 | 1 | 0 | 0 | 1 | End to end | C |
All cohort (n=151), n (%) | 5 (3.5) | 1 (0.7) | 23 (16) | 18 (12.5) | 9 (6.3) | 8 (5.3) | End to end | C |
Variable | Data |
---|---|
No. of patients | 151 |
Age (yr) | 65.8 ± 11.3, 67.0 (35–89) |
Weight (kg) | 81.7 ± 17.3, 79.0 (50–153) |
Height (m) | 1.7 ± 0.1, 1.7 (1.5–2.0) |
Body mass index (kg/m2) | 27.5 ± 4.8, 26.5 (19.6–47.2) |
> 30 | 116 (76.8) |
≤ 30 | 35 (23.2) |
Tumor distance (cm) | 21.9 ± 8.6, 20.0 (5–50) |
Lymph node count | 16.0 ± 8.7, 15.0 (1–52) |
Length of hospital stay (day) | 11.1 ± 4.2, 10.0 (2–35) |
Sex | |
Female | 55 (36.4) |
Male | 96 (63.6) |
ASA PS classification | |
I | 10 (6.6) |
II | 106 (70.2) |
III | 35 (23.2) |
Stage | |
0 | 2 (1.3) |
I | 39 (25.8) |
II | 50 (33.1) |
III | 50 (33.1) |
IV | 10 (6.6) |
Rectal tumor, 5–17 cm | |
No | 105 (69.5) |
Yes | 46 (30.5) |
Laparoscopic surgery | |
0 | 106 (70.2) |
1 | 45 (29.8) |
Open surgery | |
0 | 42 (27.8) |
1 | 109 (72.2) |
Reinforcement suture | |
0 | 80 (52.9) |
1 | 71 (47.0) |
Leak | |
0 | 144 (95.4) |
1 | 7 (4.6) |
Leak grade | |
No leak | 144 (95.4) |
A | 3 (2.0) |
B | 2 (1.3) |
C | 2 (1.3) |
Group | Reinforcement suture |
P-value | ||
---|---|---|---|---|
0 | 1 | |||
All study | ||||
Leak | 0 | 74 (93.7) | 69 (97.2) | 0.447 |
1 | 5 (6.3) | 2 (2.8) | ||
Leak grade | A | 3 (60.0) | 0 (0) | 0.429 |
B | 1 (20.0) | 1 (50.0) | ||
C | 1 (20.0) | 1 (50.0) | ||
Rectal tumor | ||||
Leak | 0 | 28 (87.5) | 13 (100) | 0.308 |
1 | 4 (12.5) | 0 (0) | ||
Leak grade | A | 3 (75.0) | 0 (0) | NA |
B | 1 (25.0) | 0 (0) | ||
C | 0 (0) | 0 (0) | ||
Sigmoid tumor | ||||
Leak | 0 | 46 (97.9) | 56 (96.6) | 1 |
1 | 1 (2.1) | 2 (3.4) | ||
Leak grade | A | 0 (0) | 0 (0) | 1 |
B | 1 (100) | 1 (50.0) | ||
C | 0 (0) | 1 (50.0) |
Variable | Leak |
P-value |
||
---|---|---|---|---|
0 | 1 | |||
BMI > 30 kg/m2 | 0 | 112 (77.8) | 4 (57.1) | 0.354 |
1 | 32 (22.2) | 3 (42.9) | ||
Rectal tumor, 5–17 cm | 0 | 102 (70.8) | 3 (42.9) | 0.201 |
1 | 42 (29.2) | 4 (57.1) | ||
Radiotherapy | 0 | 135 (93.8) | 7 (100) | > 0.999 |
1 | 9 (6.3) | 0 (0) | ||
Stage of tumor disease | 0 | 2 (1.4) | 0 (0) | 0.427 |
I | 35 (24.3) | 4 (57.1) | ||
II | 48 (33.3) | 2 (28.6) | ||
III | 49 (34.0) | 1 (14.3) | ||
IV | 10 (7.0) | 0 (0) | ||
Laparoscopic surgery | 0 | 102 (70.8) | 4 (57.1) | 0.426 |
1 | 42 (29.2) | 3 (42.9) | ||
Open surgery | 0 | 39 (27.1) | 3 (42.9) | 0.398 |
1 | 105 (72.9) | 4 (57.1) | ||
Median value | ||||
Age (yr) | 67.5 | 60.0 | 0.087 | |
Weight (kg) | 79.0 | 75.0 | 0.710 | |
BMI (kg/m2) | 26.5 | 26.0 | 0.743 | |
Tumor distance (cm) | 20.0 | 15.0 | 0.188 |
Patient No. | Risk factor |
|||||||||
---|---|---|---|---|---|---|---|---|---|---|
Sex | NS TP/Alb (g/L) | Steroids use | IBD | DM |
NSAIDs use | RT | No. of staples fired | Type of anastomose | Type of leak | |
1 | Female | 54.4/32.8 | 0 | 0 | 0 | 0 | 0 | 2 | End to end | A |
2 | Female | 48.6/27.7 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | A |
3 | Male | 41.8/20 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | A |
4 | Male | 49.6/25.4 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | B |
5 | Male | 40.9/17.5 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | B |
6 | Male | 47.4/39.4 | 0 | 0 | 0 | 0 | 0 | 1 | End to end | C |
7 | Male | 41.2/18 | 0 | 0 | 1 | 0 | 0 | 1 | End to end | C |
All cohort (n=151), n (%) | 5 (3.5) | 1 (0.7) | 23 (16) | 18 (12.5) | 9 (6.3) | 8 (5.3) | End to end | C |
Values are presented as mean±standard deviation, median (range), or number (%). ASA, American Society of Anesthesiology; PS, physical status.
Values are presented as number (%). NA, not applicable.
Values are presented as number (%) or data only. BMI, body mass index. Analyzed using Fishers exact test.
NS, nutritional status; TP/Alb, total protein/albumin; IBD, inflammatory bowel disease; DM, diabetes mellitus; NSAID, nonsteroidal anti-inflammatory drug; RT, radiotherapy. P-value for each factor is >0.999. Normal blood glucose value is 65–85 g/L×32–48 g/L.