Risk factors of postoperative anastomotic leakage in patients with colorectal cancer

Objective To explore the independent risk factors of postoperative anastomotic leakage (AL) in patients with colorectal cancer. Methods Retrospectively analyze the data of 926 patients with colorectal cancer who received surgery in the Department of Surgery, Shanghai Changzheng Hospital from Dec 2010 to Apr 2014. Through case-control analysis and chi-square test, the risk factors of AL were screened in the variables of clinicopathological classification. Multivariate analysis was used by logistic regression to screen independent risk factors. Results Hypertension, laparoscopy surgery and non-defunctioning stoma were independent risk factors for AL in overall samples (OR=1.907, 2.252, 5.556; P=0.016, 0.006, 0.001, respectively). Subgroup analysis showed that left colon was a risk factor of AL in colon cancer subgroup (OR=2.519, P=0.032). Hypertension, laparoscopic and non-defunctioning stoma were independent risk factors in rectal cancer subgroup (OR=2.597, 7.609, 9.346; P=0.012, 0.007, <0.001, respectively). Hypertension, non-defunctioning stoma and bleeding ≥ 400 mL were independent risk factors in laparoscopic subgroup (OR=2.407, 5.376, 3.922; P=0.006, 0.002, 0.001, respectively). Hypertension, laparoscopy surgery and rectal cancer were independent risk factors in non-defunctioning stoma subgroup (OR=1.969, 1.859, 1.716; P=0.015, 0.046, 0.059, respectively). Hypertension, laparoscopy surgery and operative time≥ 3 h were independent risk factors in rectal cancer patients with non-defunctioning stoma subgroup (OR=2.796, 7.346, 2.287; P=0.012, 0.008, 0.046, respectively). Conclusion For rectal cancer patients with hypertension, laparoscopic and non-defunctioning stoma, close attention should be paid and targeted prevention are needed to reduce the occurrence of postoperative AL. Key words: Colorectal neoplasms; Postoperative complications; Risk factors; ASA score