Publication: Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage
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Issued Date
2008-08-01
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ISSN
02534886
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2-s2.0-49449113858
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Mahidol University
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SCOPUS
Bibliographic Citation
Digestive Surgery. Vol.25, No.3 (2008), 191-197
Suggested Citation
Varut Lohsiriwat, Darin Lohsiriwat, Wiroon Boonnuch, Vitoon Chinswangwatanakul, Thawatchai Akaraviputh, Woramin Riansuwan, Narong Lert-Akyamanee Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage. Digestive Surgery. Vol.25, No.3 (2008), 191-197. doi:10.1159/000140688 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/19584
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Title
Outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain, and risk factors for anastomotic leakage
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Abstract
Background/Aims: To evaluate the outcomes of sphincter-saving operation for rectal cancer without protective stoma and pelvic drain and to determine factors influencing anastomotic leakage. Methods: We investigated 170 patients undergoing elective sphincter-saving operation without protective stoma and pelvic drain during 2003-2006 in a single institution. Early postoperative outcomes were evaluated. 17 independent patient-, tumor-, and treatment-related variables were analyzed by a multivariate model to determine their association with anastomotic leakage. Results: The patients' median age was 64 years. Median tumor height was 8 cm (range 3-15) from the anal verge. Overall 30-day mortality rate was 1.2%. Postoperative complications were diagnosed in 38 patients (22%) including 14 cases of anastomotic leakage (8.2%), of which 10 cases (71%) required surgical intervention. Tumor height within 5 cm from the anal verge was the only independent factor for leakage (OR 4.04; 95% CI 1.25-13.08). Conclusion: A sphincter-saving operation without a protective stoma and pelvic drain can be performed safely in the vast majority of rectal cancer patients. Tumor height within 5 cm from the anal verge is an independent risk factor for anastomotic leakage. Thus, the routine use of a protective stoma and pelvic drainage might be unnecessary. Copyright © 2008 S. Karger AG.