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A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery

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Abstract

Background

Aortoiliac calcification may be a surrogate marker of decreased visceral perfusion causing anastomotic leak (AL). The aim of this study was to evaluate the predictive role of aortoiliac calcification for AL after rectal cancer surgery.

Methods

We enrolled patients with primary rectal cancer who had restorative resection at our institution between January 2013 and December 2015. An aortoiliac calcification score was calculated as the sum of calcification scores at the infrarenal aorta (0: no, 1: ≤ 3 cm, 2: > 3 cm) and the common iliac arteries (0: no, 1: unilateral, 2: bilateral). AL was classified into three grades: grade A, requiring no intervention; grade B, requiring therapeutic intervention without re-laparotomy; and grade C, requiring re-laparotomy. Clinicopathological characteristics were analyzed to identify risk factors for AL.

Results

There were 583 patients. Three-hundred forty-five (59.2%) had an aortoiliac calcification score ≥ 3, and 37 (6.3%) patients experienced AL, in 30 cases (5.1%) grade C AL. Patients with an aortoiliac calcification score ≥ 3 had a higher incidence of grade C AL (6.7% vs. 2.9%, p = 0.045). Multivariate logistic regression analysis revealed that an aortoiliac calcification score ≥ 3 was an independent risk factor for grade C AL (odds ratio = 2.669, 95% confidence interval 1.066–6.686, p = 0.036).

Conclusions

Aortoiliac calcification may be considered a risk factor for grade C AL after rectal cancer surgery.

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Funding

The authors received no financial support for this study.

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Authors and Affiliations

  1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun, Jeonnam, 58128, South Korea

    S. Y. Lee, S.-S. Yeom, C. H. Kim, Y. J. Kim & H. R. Kim

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  1. S. Y. Lee
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  2. S.-S. Yeom
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  3. C. H. Kim
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  4. Y. J. Kim
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  5. H. R. Kim
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Correspondence to H. R. Kim.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was exempted because this retrospective study was harmless to the patients, and contained no personal data. It was approved by the institutional review board of our institution.

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Lee, S.Y., Yeom, SS., Kim, C.H. et al. A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery. Tech Coloproctol 24, 843–849 (2020). https://doi.org/10.1007/s10151-020-02246-1

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  • DOI: https://doi.org/10.1007/s10151-020-02246-1

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