July 17, 2018BMC GastroenterologyOpen Access

Male sex and history of ischemic heart disease are major risk factors for anastomotic leakage after laparoscopic anterior resection in patients with rectal cancer

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Rectal cancer (n=154). Intervention: History of ischemic heart disease vs. No history of ischemic heart disease. Primary outcome: Clinical anastomotic leakage (Clavien-Dindo ≥ 2) (OR 4.73, 95% CI 1.27-17.5, p=0.025).

Q: What does this research mean for the field?

A history of ischemic heart disease independently increases the risk of anastomotic leakage in male patients undergoing elective laparoscopic anterior resection for rectal cancer. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Ischemic heart disease linked to ~373% higher anastomotic leakage risk after male rectal cancer surgery.

OR 4.73
95% CI 1.27-17.5
P=0.025
n=154

Population

154 patients with rectal cancer treated by elective laparoscopic anterior resection with anastomosis using…

Design

Cohort

Authors

SSSeiichi ShinjiTokyo Metropolitan Institute of Gerontology YUYoshibumi UedaNational Institute of Infectious Diseases TYTakeshi YamadaUniversity of Tsukuba

Discussion

Member takes

Implication

May inform preoperative risk stratification in male patients; leaves open whether ischemic heart disease is causal or requires prospective validation.

Study Design

Type

Cohort (n=154)

Multicenter

Structured PICO

Population

154 patients (mean age 67.1 years, 35% female) with rectal cancer who underwent elective laparoscopic anterior resection with double-stapling anastomosis.

Outcome

Clinical anastomotic leakage (AL)safety

Main Result

Odds Ratio: 4.73 (95% CI 1.27–17.5)

Absolute Event Rate: 46.2% vs 8.5%

p-value: p=0.025

A history of ischemic heart disease significantly increases the risk of anastomotic leakage in male patients undergoing laparoscopic anterior resection for rectal cancer.

Limitations

Retrospective single-center design
Small number of anastomotic leakage events (n=18)
Lack of pathological confirmation of the proposed microvascular disease mechanism
Criteria for transanal drain placement were not standardized and left to surgeon discretion

Cite This Study

Shinji et al. (2018) conducted a cohort in Rectal cancer (n=154). History of ischemic heart disease vs. No history of ischemic heart disease was evaluated on Clinical anastomotic leakage (Clavien-Dindo ≥ 2) (OR 4.73, 95% CI 1.27-17.5, p=0.025). A history of ischemic heart disease independently increased the risk of anastomotic leakage (OR 4.73) in male patients undergoing elective laparoscopic anterior resection for rectal cancer.

synapsesocial.com/papers/6aa942c96dc8754dbe62eb62 https://doi.org/10.1186/s12876-018-0846-3

Topics

Women and heart disease

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Implication

May inform preoperative risk stratification in male patients; leaves open whether ischemic heart disease is causal or requires prospective validation.

Male sex and history of ischemic heart disease are major risk factors for anastomotic leakage after laparoscopic anterior resection in patients with rectal cancer

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Male sex and history of ischemic heart disease are major risk factors for anastomotic leakage after laparoscopic anterior resection in patients with rectal cancer

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider