Abstract
This study aims to validate the oncologic outcomes of anastomotic leakage (AL) after laparoscopic total mesorectal excision (TME) in a large multicenter cohort. The impact of AL after laparoscopic TME for rectal cancer surgery has not yet been clearly described. This was a multicenter retrospective study of 1083 patients who underwent laparoscopic TME for nonmetastatic rectal cancer (stage 0-III). AL was defined as an anastomotic complication within 30 days of surgery irrespective of requiring a reoperation or interventional radiology. Estimated local recurrence (LR), disease-free survival (DFS), and overall survival (OS) were compared between the leakage group and the no leakage group using the log-rank method. Multivariate Cox-regression analysis was used to adjust confounding for survival. The incidence of AL was 6.4%. Mortality within 30 days of surgery occurred in 1 patient (1.4%) in the leakage group and 2 patients (0.2%) in the no leakage group. The leakage group showed a higher LR rate (6.4% vs 1.8%, P=0.011). Five-year DFS and OS were significantly lower in the leakage group than the no leakage group (DFS 71.7% vs 82.1%, P=0.016, OS 81.8% vs 93.5%, P=0.007). Multivariate analysis showed that AL was an independent poor prognostic factor for DFS and OS (hazard ratio [HR]=1.6; 95% confidence intervals [CI]: 1.0-2.6; P=0.042, HR=2.1; 95% CI: 1.0-4.2; P=0.028, respectively). AL after laparoscopic TME was significantly associated with an increased rate of LR, systemic recurrence and poor OS.
| Original language | English |
|---|---|
| Article number | e1202 |
| Journal | Medicine (United States) |
| Volume | 94 |
| Issue number | 29 |
| DOIs | |
| Publication status | Published - 2015 Jul 1 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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Multicenter analysis of long-Term oncologic impact of anastomotic leakage after laparoscopic total mesorectal excision : The Korean laparoscopic colorectal surgery study group. / Kang, Jeonghyun; Choi, Gyu Seog; Oh, Jae Hwan; Kim, Nam Kyu; Park, Jun Seok; Kim, Min Jung; Lee, Kang Young; Baik, Seung Hyuk.
In: Medicine (United States), Vol. 94, No. 29, e1202, 01.07.2015.Research output: Contribution to journal › Article
TY - JOUR
T1 - Multicenter analysis of long-Term oncologic impact of anastomotic leakage after laparoscopic total mesorectal excision
T2 - The Korean laparoscopic colorectal surgery study group
AU - Kang, Jeonghyun
AU - Choi, Gyu Seog
AU - Oh, Jae Hwan
AU - Kim, Nam Kyu
AU - Park, Jun Seok
AU - Kim, Min Jung
AU - Lee, Kang Young
AU - Baik, Seung Hyuk
PY - 2015/7/1
Y1 - 2015/7/1
N2 - This study aims to validate the oncologic outcomes of anastomotic leakage (AL) after laparoscopic total mesorectal excision (TME) in a large multicenter cohort. The impact of AL after laparoscopic TME for rectal cancer surgery has not yet been clearly described. This was a multicenter retrospective study of 1083 patients who underwent laparoscopic TME for nonmetastatic rectal cancer (stage 0-III). AL was defined as an anastomotic complication within 30 days of surgery irrespective of requiring a reoperation or interventional radiology. Estimated local recurrence (LR), disease-free survival (DFS), and overall survival (OS) were compared between the leakage group and the no leakage group using the log-rank method. Multivariate Cox-regression analysis was used to adjust confounding for survival. The incidence of AL was 6.4%. Mortality within 30 days of surgery occurred in 1 patient (1.4%) in the leakage group and 2 patients (0.2%) in the no leakage group. The leakage group showed a higher LR rate (6.4% vs 1.8%, P=0.011). Five-year DFS and OS were significantly lower in the leakage group than the no leakage group (DFS 71.7% vs 82.1%, P=0.016, OS 81.8% vs 93.5%, P=0.007). Multivariate analysis showed that AL was an independent poor prognostic factor for DFS and OS (hazard ratio [HR]=1.6; 95% confidence intervals [CI]: 1.0-2.6; P=0.042, HR=2.1; 95% CI: 1.0-4.2; P=0.028, respectively). AL after laparoscopic TME was significantly associated with an increased rate of LR, systemic recurrence and poor OS.
AB - This study aims to validate the oncologic outcomes of anastomotic leakage (AL) after laparoscopic total mesorectal excision (TME) in a large multicenter cohort. The impact of AL after laparoscopic TME for rectal cancer surgery has not yet been clearly described. This was a multicenter retrospective study of 1083 patients who underwent laparoscopic TME for nonmetastatic rectal cancer (stage 0-III). AL was defined as an anastomotic complication within 30 days of surgery irrespective of requiring a reoperation or interventional radiology. Estimated local recurrence (LR), disease-free survival (DFS), and overall survival (OS) were compared between the leakage group and the no leakage group using the log-rank method. Multivariate Cox-regression analysis was used to adjust confounding for survival. The incidence of AL was 6.4%. Mortality within 30 days of surgery occurred in 1 patient (1.4%) in the leakage group and 2 patients (0.2%) in the no leakage group. The leakage group showed a higher LR rate (6.4% vs 1.8%, P=0.011). Five-year DFS and OS were significantly lower in the leakage group than the no leakage group (DFS 71.7% vs 82.1%, P=0.016, OS 81.8% vs 93.5%, P=0.007). Multivariate analysis showed that AL was an independent poor prognostic factor for DFS and OS (hazard ratio [HR]=1.6; 95% confidence intervals [CI]: 1.0-2.6; P=0.042, HR=2.1; 95% CI: 1.0-4.2; P=0.028, respectively). AL after laparoscopic TME was significantly associated with an increased rate of LR, systemic recurrence and poor OS.
UR - http://www.scopus.com/inward/record.url?scp=84942430475&partnerID=8YFLogxK
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U2 - 10.1097/MD.0000000000001202
DO - 10.1097/MD.0000000000001202
M3 - Article
C2 - 26200636
AN - SCOPUS:84942430475
VL - 94
JO - Medicine (United States)
JF - Medicine (United States)
SN - 0025-7974
IS - 29
M1 - e1202
ER -