Risk factors for anatomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique

Abstract

Objective: This study aimed to identify the risk factors for anastomotic leakage after laparoscopic (intracorporeal) colorectal anastomosis with a double stapling technique at University Medical Center (UMC), Ho Chi Minh City.

Patients and Methods: Retrospective study. Between 2008 and 2014, a total of 227 patients underwent laparoscopic rectal resection including anterior and low anterior resection. We identified risk factors for anastomotic leakage after using double stapling technique in laparoscopic rectal resection by univariate analysis.

Results: There were 227 patients enrolled in study, male accounted for 51%, median age was 67. The location rate of a tumor above the anterior peritoneal reflection was 55.5%, stage III accounted for 91.6%. Anastomotic leakage rate was 4.8%. Anastomotic leakage rate of tumors located above anterior peritoneal reflection (Ra) was higher than those below anterior peritoneal reflection (Rb) (p=0.03). Other factors such as tumor size, stage, neoadjuvant chemo-radiotherapy, protective ileostomy and number of stapler firings were not significantly associated with anastomotic leakage risk.

Conclusion: Anastomotic leakage rate after laparoscopic (intracorporeal) colorectal anastomosis with a double stapling technique was 4.8%. Tumor location was the risk factor of anastomotic leakage. Anastomotic leakage rate of tumors located above anterior peritoneal reflection was higher than those below, accounting for 7.9% and 1%,respectively.

Keywords: Laparoscopic rectal resection using double stapling technique, anastomotic leakage, risk factor.

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