Toshiaki Watanabe1, Hiroaki Miyata2, Hiroyuki Konno3, Kazushige Kawai4, Soichiro Ishihara4, Eiji Sunami4, Norimichi Hirahara5, Go Wakabayashi4, Mitsukazu Gotoh4, Masaki Mori6. 1. Japanese Society of Gastroenterological Surgery, Database Committee Working Group, Tokyo, Japan. Electronic address: toshwatanabe@yahoo.co.jp. 2. Japanese Society of Gastroenterological Surgery, Database Committee Working Group, Tokyo, Japan; National Clinical Database, Tokyo, Japan. 3. Japanese Society of Gastroenterological Surgery, Database Committee Working Group, Tokyo, Japan. 4. Japanese Society of Gastroenterological Surgery, Tokyo, Japan. 5. National Clinical Database, Tokyo, Japan. 6. National Clinical Database, Tokyo, Japan; Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Abstract
BACKGROUND: Low anterior resection is associated with a relatively high incidence of postoperative morbidities, including anastomotic leakage and other operative site infections, which sometimes result in postoperative mortality. Therefore, recognition of the incidence and risk factors of postoperative complications following low anterior resection is essential. METHODS: Data from the National Clinical Database on patients who had undergone low anterior resection in 2011 and 2012 were retrospectively analyzed. Multiple logistic regression analyses were performed to generate predictive models of postoperative complications. Receiver-operator characteristic curves were generated, and the concordance index was used to assess the model's discriminatory ability. RESULTS: The number of patients who had undergone low anterior resection was 33,411. Seven complications, namely, overall operative site infections except for leakage, anastomotic leakage, urinary tract infection, pneumonia, renal failure, systemic sepsis, and cardiac events, were selected to construct statistical risk models. The concordance indices for the first 2 complications, which were dependent on the operative procedure, were relatively low (0.593-0.625), and the other 5, unrelated to operative procedures, showed high concordance indices (0.643-0.799). CONCLUSION: This study created the world's second risk calculator to predict the complications of low anterior resection as a model based on mass nationwide data. In particular, this model is the first to predict anastomotic leakage.
BACKGROUND: Low anterior resection is associated with a relatively high incidence of postoperative morbidities, including anastomotic leakage and other operative site infections, which sometimes result in postoperative mortality. Therefore, recognition of the incidence and risk factors of postoperative complications following low anterior resection is essential. METHODS: Data from the National Clinical Database on patients who had undergone low anterior resection in 2011 and 2012 were retrospectively analyzed. Multiple logistic regression analyses were performed to generate predictive models of postoperative complications. Receiver-operator characteristic curves were generated, and the concordance index was used to assess the model's discriminatory ability. RESULTS: The number of patients who had undergone low anterior resection was 33,411. Seven complications, namely, overall operative site infections except for leakage, anastomotic leakage, urinary tract infection, pneumonia, renal failure, systemic sepsis, and cardiac events, were selected to construct statistical risk models. The concordance indices for the first 2 complications, which were dependent on the operative procedure, were relatively low (0.593-0.625), and the other 5, unrelated to operative procedures, showed high concordance indices (0.643-0.799). CONCLUSION: This study created the world's second risk calculator to predict the complications of low anterior resection as a model based on mass nationwide data. In particular, this model is the first to predict anastomotic leakage.
Authors: Philip Plaeke; Joris G De Man; Samuel Coenen; Philippe G Jorens; Benedicte Y De Winter; Guy Hubens Journal: Surg Today Date: 2019-06-06 Impact factor: 2.549
Authors: Johannes Klose; Ignazio Tarantino; Armin von Fournier; Moritz J Stowitzki; Yakup Kulu; Thomas Bruckner; Claudia Volz; Thomas Schmidt; Martin Schneider; Markus W Büchler; Alexis Ulrich Journal: J Gastrointest Surg Date: 2018-05-18 Impact factor: 3.452
Authors: V Lin; A Tsouchnika; E Allakhverdiiev; A W Rosen; M Gögenur; J S R Clausen; K B Bräuner; J S Walbech; P Rijnbeek; I Drakos; I Gögenur Journal: Tech Coloproctol Date: 2022-05-20 Impact factor: 3.699
Authors: Kevin Phan; Lawrence Oh; Grahame Ctercteko; Nimalan Pathma-Nathan; Toufic El Khoury; Hamza Azam; Danette Wright; James Wei Tatt Toh Journal: J Gastrointest Oncol Date: 2019-04