Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors
Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection...
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| Veröffentlicht in: | World journal of gastrointestinal oncology 2019-07, Vol.11 (7), p.538-550 |
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| creator | Wang, Zhi-Jie Tao, Jin-Hua Chen, Jia-Nan Mei, Shi-Wen Shen, Hai-Yu Zhao, Fu-Qiang Liu, Qian |
| description | Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL.
To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms.
This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis.
The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (
= 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (
= 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042;
= 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer.
Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carc |
| doi_str_mv | 10.4251/wjgo.v11.i7.538 |
| format | Article |
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To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms.
This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis.
The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (
= 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (
= 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042;
= 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer.
Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carcinoma, but it also increases the risk of AL following the anterior resection of rectal neoplasms.</description><identifier>ISSN: 1948-5204</identifier><identifier>EISSN: 1948-5204</identifier><identifier>DOI: 10.4251/wjgo.v11.i7.538</identifier><identifier>PMID: 31367273</identifier><language>eng</language><publisher>China: Baishideng Publishing Group Inc</publisher><subject>Retrospective Cohort Study</subject><ispartof>World journal of gastrointestinal oncology, 2019-07, Vol.11 (7), p.538-550</ispartof><rights>The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. 2019</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-67c04a6aee47dfc7e8a0ad7f3b67c7cd534b9abd0a883abf7404e044dd824203</citedby><cites>FETCH-LOGICAL-c393t-67c04a6aee47dfc7e8a0ad7f3b67c7cd534b9abd0a883abf7404e044dd824203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657222/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6657222/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31367273$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Zhi-Jie</creatorcontrib><creatorcontrib>Tao, Jin-Hua</creatorcontrib><creatorcontrib>Chen, Jia-Nan</creatorcontrib><creatorcontrib>Mei, Shi-Wen</creatorcontrib><creatorcontrib>Shen, Hai-Yu</creatorcontrib><creatorcontrib>Zhao, Fu-Qiang</creatorcontrib><creatorcontrib>Liu, Qian</creatorcontrib><title>Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors</title><title>World journal of gastrointestinal oncology</title><addtitle>World J Gastrointest Oncol</addtitle><description>Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL.
To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms.
This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis.
The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (
= 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (
= 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042;
= 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer.
Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carcinoma, but it also increases the risk of AL following the anterior resection of rectal neoplasms.</description><subject>Retrospective Cohort Study</subject><issn>1948-5204</issn><issn>1948-5204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpVUT1PwzAQtRAIUOnMhjKytDi2E6cLEkJ8SUgs3a2Lc2kNSVxst4idH85FfAg82Pf8np_v9Bg7zflciSK_eHte-fkuz-dOzwtZ7bHjfKGqWSG42v9TH7FpjM-cllKa5_yQHclcllpoecw-HoYUwG8wQHI7zNwICbnkB4Qus2vsfVoTvXkn0gaEiDGjmxG5BgeLmW8zGCAmT1Jnsw7hBVaYQZswEEO78yELGNEm54dRH6gk-7TtfYgn7KCFLuL0-5yw5e3N8vp-9vh093B99TizciHTrNSWKygBUemmtRor4NDoVtbEaNsUUtULqBsOVSWhbrXiCmnopqmEElxO2OWX7WZb99hYHGftzCa4HsK78eDMf2Zwa7PyO1OWhRZCkMH5t0Hwr1uMyfQuWuw6GNBvoxGi1Fpp6oOkF19SG3yMAdvfb3JuxvTMmJ6h9IzThtKjF2d_u_vV_2QlPwH1Xp1e</recordid><startdate>20190715</startdate><enddate>20190715</enddate><creator>Wang, Zhi-Jie</creator><creator>Tao, Jin-Hua</creator><creator>Chen, Jia-Nan</creator><creator>Mei, Shi-Wen</creator><creator>Shen, Hai-Yu</creator><creator>Zhao, Fu-Qiang</creator><creator>Liu, Qian</creator><general>Baishideng Publishing Group Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190715</creationdate><title>Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors</title><author>Wang, Zhi-Jie ; Tao, Jin-Hua ; Chen, Jia-Nan ; Mei, Shi-Wen ; Shen, Hai-Yu ; Zhao, Fu-Qiang ; Liu, Qian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-67c04a6aee47dfc7e8a0ad7f3b67c7cd534b9abd0a883abf7404e044dd824203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Retrospective Cohort Study</topic><toplevel>online_resources</toplevel><creatorcontrib>Wang, Zhi-Jie</creatorcontrib><creatorcontrib>Tao, Jin-Hua</creatorcontrib><creatorcontrib>Chen, Jia-Nan</creatorcontrib><creatorcontrib>Mei, Shi-Wen</creatorcontrib><creatorcontrib>Shen, Hai-Yu</creatorcontrib><creatorcontrib>Zhao, Fu-Qiang</creatorcontrib><creatorcontrib>Liu, Qian</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of gastrointestinal oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Zhi-Jie</au><au>Tao, Jin-Hua</au><au>Chen, Jia-Nan</au><au>Mei, Shi-Wen</au><au>Shen, Hai-Yu</au><au>Zhao, Fu-Qiang</au><au>Liu, Qian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors</atitle><jtitle>World journal of gastrointestinal oncology</jtitle><addtitle>World J Gastrointest Oncol</addtitle><date>2019-07-15</date><risdate>2019</risdate><volume>11</volume><issue>7</issue><spage>538</spage><epage>550</epage><pages>538-550</pages><issn>1948-5204</issn><eissn>1948-5204</eissn><abstract>Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL.
To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms.
This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis.
The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (
= 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (
= 0.044). A multivariate analysis was subsequently performed to adjust for the confounding factors and also showed that intraoperative intraperitoneal chemotherapy increased the incidence of AL (odds ratio = 5.386; 95%CI: 1.808-16.042;
= 0.002). However, the survival analysis demonstrated that intraoperative intraperitoneal chemotherapy could also improve the disease-free survival rates for patients with locally advanced rectal cancer.
Intraoperative intraperitoneal chemotherapy can improve the prognosis of patients with locally advanced rectal carcinoma, but it also increases the risk of AL following the anterior resection of rectal neoplasms.</abstract><cop>China</cop><pub>Baishideng Publishing Group Inc</pub><pmid>31367273</pmid><doi>10.4251/wjgo.v11.i7.538</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| source | Baishideng "World Journal of" online journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Retrospective Cohort Study |
| title | Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors |
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