Risk Factors for Anastomotic Leakage after Laparoscopic Anterior Resection Using the Double Stapling Technique: Is the Circular Staple Diameter a Risk Factor for Anastomotic Leakage?

Abstract

Objective: This study aimed to analyze the risk factors for leakage in laparoscopic rectal cancer surgery.

Methods: We retrospectively examined 112 patients who underwent anastomosis with the double stapling technique in laparoscopic rectal cancer surgery at our hospital. To identify the risk factors, we analyzed age, sex, body mass index, diabetes, preoperative albumin level, preoperative bowel obstruction, tumor location, invasion depth of tumor, and Prognostic Nutritional Index as the patient factors. As the surgery factors, we analyzed operation time, amount of bleeding, number of firings for rectal transection, reduced port surgery, ligation of the inferior mesenteric artery root, size of the circular stapler, and covering stoma.

Results: The median age of the 112 patients was 67 years. Twelve patients had anastomotic leakage. A significant difference was confirmed for circular staple size (31 mm or more) and operation time (400 minutes or longer). Multivariate analysis revealed that a circular staple size of 31 mm or more was an independent risk factor for anastomotic leakage.

Conclusion: The findings of this study suggested that circular staple size is a risk factor for anastomotic leakage.