Nomogram for predicting 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 predictio...

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Veröffentlicht in:International journal of colorectal disease 2018-04, Vol.33 (4), p.411-418
Hauptverfasser: Hoshino, Nobuaki, Hida, Koya, Sakai, Yoshiharu, Osada, Shunichi, Idani, Hitoshi, Sato, Toshihiko, Takii, Yasumasa, Bando, Hiroyuki, Shiomi, Akio, Saito, Norio
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Sprache:eng
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Zusammenfassung: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.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-018-2970-5