Nobuaki Hoshino1, Koya Hida2, Yoshiharu Sakai1, Shunichi Osada3, Hitoshi Idani4, Toshihiko Sato5, Yasumasa Takii6, Hiroyuki Bando7, Akio Shiomi8, Norio Saito9. 1. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 2. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. hidakoya@kuhp.kyoto-u.ac.jp. 3. Division of Surgery, Yokohama City Minato Red Cross Hospital, Kanagawa, Japan. 4. Division of Surgery, Fukuyama City Hospital, Fukuyama, Japan. 5. Division of Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. 6. Division of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan. 7. Division of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Ishikawa, Japan. 8. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. 9. Division of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan.
Abstract
PURPOSE: Anastomotic leakage after low anterior resection for rectal cancer is a critical problem. Many risk factors have been suggested and surgical techniques have improved, but anastomotic leakage remains a major postoperative challenge. This study sought to create a nomogram for precise prediction of anastomotic leakage after low anterior resection for rectal cancer. METHODS: We used data of 936 patients that had been prospectively collected by the Japanese Society for Colon and Rectal Cancer between June 2010 and February 2013. Risk factors for anastomotic leakage were identified by multivariate logistic regression analysis and used to create a nomogram. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots. RESULTS: Sex, preoperative serum albumin, tumor location and diameter, and simultaneous resection of other organs were identified as significantly associated factors that could be combined for accurate prediction of anastomotic leakage. We created a nomogram for anastomotic leakage by using these risk factors. The area under the curve was 0.72 (95% confidence interval 0.67-0.76). The nomogram had a bootstrapped-concordance index of 0.72 and was well calibrated. CONCLUSIONS: Our nomogram was a useful tool for precise prediction of anastomotic leakage after low anterior resection for rectal cancer.
PURPOSE:Anastomotic leakage after low anterior resection for rectal cancer is a critical problem. Many risk factors have been suggested and surgical techniques have improved, but anastomotic leakage remains a major postoperative challenge. This study sought to create a nomogram for precise prediction of anastomotic leakage after low anterior resection for rectal cancer. METHODS: We used data of 936 patients that had been prospectively collected by the Japanese Society for Colon and Rectal Cancer between June 2010 and February 2013. Risk factors for anastomotic leakage were identified by multivariate logistic regression analysis and used to create a nomogram. The performance of the nomogram was evaluated by using a bootstrapped-concordance index and calibration plots. RESULTS: Sex, preoperative serum albumin, tumor location and diameter, and simultaneous resection of other organs were identified as significantly associated factors that could be combined for accurate prediction of anastomotic leakage. We created a nomogram for anastomotic leakage by using these risk factors. The area under the curve was 0.72 (95% confidence interval 0.67-0.76). The nomogram had a bootstrapped-concordance index of 0.72 and was well calibrated. CONCLUSIONS: Our nomogram was a useful tool for precise prediction of anastomotic leakage after low anterior resection for rectal cancer.
Authors: K C M J Peeters; R A E M Tollenaar; C A M Marijnen; E Klein Kranenbarg; W H Steup; T Wiggers; H J Rutten; C J H van de Velde Journal: Br J Surg Date: 2005-02 Impact factor: 6.939
Authors: C La Raja; C Foppa; A Maroli; C Kontovounisios; N Ben David; M Carvello; A Spinelli Journal: Tech Coloproctol Date: 2022-03-28 Impact factor: 3.699