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Cited 15 time in webofscience Cited 14 time in scopus
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Risk factors causing structural sequelae after anastomotic leakage in mid to low rectal cancer

Authors
Ji, Woong BaeKwak, Jung MyunKim, JinUm, Jun WonKim, Seon Hahn
Issue Date
21-May-2015
Publisher
BAISHIDENG PUBLISHING GROUP INC
Keywords
Anastomotic leakage; Permanent stoma; Leakage sequelae; rectal cancer; Anastomotic leakage fate
Citation
WORLD JOURNAL OF GASTROENTEROLOGY, v.21, no.19, pp 5910 - 5917
Pages
8
Indexed
SCIE
SCOPUS
Journal Title
WORLD JOURNAL OF GASTROENTEROLOGY
Volume
21
Number
19
Start Page
5910
End Page
5917
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/7878
DOI
10.3748/wjg.v21.i19.5910
ISSN
1007-9327
2219-2840
Abstract
AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer. METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae (stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma (PS) and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage. RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients (39.7%). Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio (OR) = 6.741; P = 0.017]. Fourteen patients (17.7%) had permanent stoma during the follow-up period (median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma (OR = 0.751; P = 0.045). CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.
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Kim, Jin
Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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