Correlation Analysis of Preoperative Nutritional Risk and Anastomotic Leakage Following Anterior Resection for Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 SHENLian-dong , QIWen-hai

Department of Anorectal Surgery, Affiliated Hospital of Yanan University, Yanan 716000, Shan'xi Province, China;

Corresponding?author：

SHENLian-dong, Email: shen100000000@163.com

Keywords：

Rectal cancer; Anterior resction; Nutrional risk screening; Anastomotic leakage

DOI：

10.7507/1007-9424.20160120

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the association between the preoperative nutritional risk and anastomotic leakage following anterior resection for the rectal cancer. Methods A total of 321 patients with rectal cancer underwent anterior resection in our hospital between January 2008 and December 2013 were retrospectively analyzed. Preoperative nutritional status was evaluated using NRS 2002. Correlation of clinicopathologic characteristics with postoperative anastomotic leakage was evaluated using single factor analysis and Logistic regression model. Results Among the 321 patients, the incidence of postoperative anastomotic leakage was 5.6% (18/321). Single factor analysis showed that the NRS2002 score≥3, clinicalpathologic stage (Ⅲ-Ⅳstage) and distance of tumor from the anal verge were the risk factors of anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Logistic regression analysis revealed that the NRS2002 score (OR=4.125, 95% CI=2.062-7.004), clinicalpathologic stage (OR=3.334, 95% CI=2.062-7.004) and the distance of tumor from the anal verge (OR=2.341, 95% CI=2.559-15.838) were the independent risk factors for anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Conciusions Preoperative NRS2002 score is helpful to predict the risk of anastomotic leakage after anterior resection of rectal cancer. Nutrition education should be strengthened to decrease the morbidity of the anastomotic leakage following anterior resection for the patients who's NRS2002 score≥3.

Citation： SHENLian-dong, QIWen-hai. Correlation Analysis of Preoperative Nutritional Risk and Anastomotic Leakage Following Anterior Resection for Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(4): 454-457. doi: 10.7507/1007-9424.20160120 Copy

1.	江志偉, 黎介壽.腫瘤營養學的指南與實踐.腸外與腸內營養, 2012, 19(1): 1-2.
2.	何裕隆.直腸癌根治術后營養相關并發癥與干預.中華普外科手術學雜志:電子版, 2014, 8(2): 134-137.
3.	Kang CY, Halabi WJ, Chaudhry OO, et al. Risk factors for anastomotic leakage after anterior resection for rectal cancer. JAMA Surg, 2013, 148(1): 65-71.
4.	Akiyoshi T, Ueno M, Fukunaga Y, et al. Incidence of and risk factors for anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer. Am J Surg, 2011, 202(3): 259-264.
5.	徐建, 李釗, 李浩, 等.腹腔鏡直腸癌前切除術吻合口瘺危險因素分析.臨床外科雜志, 2015, 23(4): 266-268.
6.	于寅波, 陳璽華, 孫國安, 等.直腸癌前切除術后吻合口瘺的高危因素分析.中國基層醫藥, 2013, 20(5): 724-725.
7.	高麗萍, 楊美富.中低位直腸癌保肛術后吻合口瘺相關因素及預防.中國藥物與臨床, 2015, 15(2): 226-228.
8.	李思源, 趙鵬, 李洪波, 等.結直腸癌術后吻合口瘺的危險因素分析.中國現代普通外科進展, 2015, 18(2): 163-164.
9.	Park JS, Choi GS, Kim SH, et al.Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision:the Korean laparoscopic colorectal surgery study group. Ann Surg, 2013, 257(4): 665-671.
10.	Trencheva K, Morrissey KP, Wells M, et al. Identifying important predictors for anastomotic leak after colon and rectal resection:prospective study on 616 patients. Ann Surg, 2013, 257(1): 108-113.
11.	Ziegler MA, Catto JA, Riggs TW, et al. Risk factors for anastomotic leak and mortality in diabetic patients undergoing colectomy: analysis from a statewide surgical quality collaborative. Arch Surg, 2012, 147(7): 600-605.
12.	傅平, 周凱, 徐連強, 等.營養風險篩查在胃腸腫瘤患者圍手術期中的應用.廣東醫學, 2014, 35(23): 3681-3683.
13.	高俊, 邱秀娟, 王琦三, 等.營養風險篩查對胃癌手術并發癥發生率的預測價值.中國腫瘤臨床, 2015, 42(5): 271-276.
14.	韓東, 賀軍, 黃秋林, 等.三種術前營養評價方法對消化道惡性腫瘤患者術后并發癥預測價值比較.中華胃腸外科雜志, 2013, 16(11): 1067-1072.
15.	梁珣, 徐桂華.營養風險篩查2002和患者總體主觀評分法在食管癌術前患者中的應用.中國實用護理雜志, 2013, 29(22): 27-29.
16.	吳國豪.重視惡性腫瘤患者的營養不良及防治.中國腫瘤臨床, 2014, 41(8): 1145-1149.
17.	Zhou W, Xu X, Yan J, et al. Nutritional risk is still a clinical predictor of postoperative outcomes in laparoscopic abdominal surgery. Surg Endosc, 2013, 27(7): 2569-2574.
18.	Jie B, Jiang Z M, Nolan M T, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: A multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, 26(11): 1088–1093.
19.	彭昌兵, 莊文.低位直腸癌保肛術后吻合口漏的原因及防治現狀.中國普外基礎與臨床雜志, 2014, 02: 251.
20.	李世邦, 劉牧林, 孔令尚, 等.我國直腸癌前切除術后發生吻合口瘺危險因素的Meta分析.中華普通外科學文獻:電子版, 2013, 7(3): 222-230.
21.	周冉, 陳武科, 何建軍, 等.國內直腸癌術后吻合口瘺危險因素的Meta分析.西安交通大學學報, 2010, 31(1): 115-121.
22.	方玉, 楊銳, 辛曉偉, 等.消化道惡性腫瘤病人營養支持現況調查.腸外與腸內營養, 2014, 12(1): 31-34.
23.	Shekarriz H, Eigenwald J, Shekarriz B, et al. Anastomotic leak in colorectal surgery: are 75% preventable. Int J Colorectal Dis, 2015, 30(11): 1525-1531.
24.	Midura EF, Dennis H, Davis BR, et al. Risk factors and consequences of anastomotic leak after colectomy: a national analysis. Dis Colon Rectum, 2015, 58(3): 33-8.
25.	吳黎敏, 周鳳如, 林慶凡, 等.營養風險篩查對結直腸癌手術死亡率和并發癥發生率的預測價值.中華胃腸外科雜志, 2011, 14(4): 271-274.

1. 江志偉, 黎介壽.腫瘤營養學的指南與實踐.腸外與腸內營養, 2012, 19(1): 1-2.
2. 何裕隆.直腸癌根治術后營養相關并發癥與干預.中華普外科手術學雜志:電子版, 2014, 8(2): 134-137.
3. Kang CY, Halabi WJ, Chaudhry OO, et al. Risk factors for anastomotic leakage after anterior resection for rectal cancer. JAMA Surg, 2013, 148(1): 65-71.
4. Akiyoshi T, Ueno M, Fukunaga Y, et al. Incidence of and risk factors for anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer. Am J Surg, 2011, 202(3): 259-264.
5. 徐建, 李釗, 李浩, 等.腹腔鏡直腸癌前切除術吻合口瘺危險因素分析.臨床外科雜志, 2015, 23(4): 266-268.
6. 于寅波, 陳璽華, 孫國安, 等.直腸癌前切除術后吻合口瘺的高危因素分析.中國基層醫藥, 2013, 20(5): 724-725.
7. 高麗萍, 楊美富.中低位直腸癌保肛術后吻合口瘺相關因素及預防.中國藥物與臨床, 2015, 15(2): 226-228.
8. 李思源, 趙鵬, 李洪波, 等.結直腸癌術后吻合口瘺的危險因素分析.中國現代普通外科進展, 2015, 18(2): 163-164.
9. Park JS, Choi GS, Kim SH, et al.Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision:the Korean laparoscopic colorectal surgery study group. Ann Surg, 2013, 257(4): 665-671.
10. Trencheva K, Morrissey KP, Wells M, et al. Identifying important predictors for anastomotic leak after colon and rectal resection:prospective study on 616 patients. Ann Surg, 2013, 257(1): 108-113.
11. Ziegler MA, Catto JA, Riggs TW, et al. Risk factors for anastomotic leak and mortality in diabetic patients undergoing colectomy: analysis from a statewide surgical quality collaborative. Arch Surg, 2012, 147(7): 600-605.
12. 傅平, 周凱, 徐連強, 等.營養風險篩查在胃腸腫瘤患者圍手術期中的應用.廣東醫學, 2014, 35(23): 3681-3683.
13. 高俊, 邱秀娟, 王琦三, 等.營養風險篩查對胃癌手術并發癥發生率的預測價值.中國腫瘤臨床, 2015, 42(5): 271-276.
14. 韓東, 賀軍, 黃秋林, 等.三種術前營養評價方法對消化道惡性腫瘤患者術后并發癥預測價值比較.中華胃腸外科雜志, 2013, 16(11): 1067-1072.
15. 梁珣, 徐桂華.營養風險篩查2002和患者總體主觀評分法在食管癌術前患者中的應用.中國實用護理雜志, 2013, 29(22): 27-29.
16. 吳國豪.重視惡性腫瘤患者的營養不良及防治.中國腫瘤臨床, 2014, 41(8): 1145-1149.
17. Zhou W, Xu X, Yan J, et al. Nutritional risk is still a clinical predictor of postoperative outcomes in laparoscopic abdominal surgery. Surg Endosc, 2013, 27(7): 2569-2574.
18. Jie B, Jiang Z M, Nolan M T, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: A multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals. Nutrition, 2010, 26(11): 1088–1093.
19. 彭昌兵, 莊文.低位直腸癌保肛術后吻合口漏的原因及防治現狀.中國普外基礎與臨床雜志, 2014, 02: 251.
20. 李世邦, 劉牧林, 孔令尚, 等.我國直腸癌前切除術后發生吻合口瘺危險因素的Meta分析.中華普通外科學文獻:電子版, 2013, 7(3): 222-230.
21. 周冉, 陳武科, 何建軍, 等.國內直腸癌術后吻合口瘺危險因素的Meta分析.西安交通大學學報, 2010, 31(1): 115-121.
22. 方玉, 楊銳, 辛曉偉, 等.消化道惡性腫瘤病人營養支持現況調查.腸外與腸內營養, 2014, 12(1): 31-34.
23. Shekarriz H, Eigenwald J, Shekarriz B, et al. Anastomotic leak in colorectal surgery: are 75% preventable. Int J Colorectal Dis, 2015, 30(11): 1525-1531.
24. Midura EF, Dennis H, Davis BR, et al. Risk factors and consequences of anastomotic leak after colectomy: a national analysis. Dis Colon Rectum, 2015, 58(3): 33-8.
25. 吳黎敏, 周鳳如, 林慶凡, 等.營養風險篩查對結直腸癌手術死亡率和并發癥發生率的預測價值.中華胃腸外科雜志, 2011, 14(4): 271-274.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Correlation Analysis of Preoperative Nutritional Risk and Anastomotic Leakage Following Anterior Resection for Rectal Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content