title: Risk factors for anastomotic leakage following anterior resection for colorectal cancer: the effect of epidural analgesia on occurrence.
abstract: OBJECTIVE
  The effect of thoracic epidural analgesia (TEA) on anastomotic leakage (AL) after anterior resection for colorectal cancer is controversial. The aim of this study was to evaluate the risk factors including TEA for the occurrence of AL after anterior resection for colorectal cancer.
  
  
  METHODS
  This retrospective study included 1,312 patients with colorectal cancer who underwent anterior resection between 2000 and 2011 at the Cancer Center, Sun Yat-sen University. Univariate and multivariate logistics analyses were performed to determine the risk factors, including TEA, for AL. Additionally, we evaluated the effect of TEA on outcome parameters.
  
  
  RESULTS
  AL occurred in 118 (9 %) of the 1,312 patients. In univariate analysis, the American Society of Anesthesiologists (ASA) score, history of hypertension, episodes of hypotension, anastomosis technique, tumor localization, anesthesia duration, and perioperative blood transfusion were significant risk factors for AL. Multivariate analysis showed that ASA (P = 0.001), perioperative blood transfusion (P < 0.001), anastomosis technique (P = 0.019), anesthesia duration (P = 0.033), and tumor localization (P = 0.009) were independent factors affecting AL. TEA had no effect on the occurrence of AL (P = 0.451) in multivariate analysis. However, the length of hospital stay was shortened by the use of TEA (P < 0.001).
  
  
  CONCLUSIONS
  The results of this retrospective study suggest that TEA has no effect on the occurrence of AL. However, TEA may be recommended to shorten the length of hospital stay.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.
authors.forename: Renchun
authors.initials: R
authors.lastname: Lai
authors.forename: Yali
authors.initials: Y
authors.lastname: Lu
authors.forename: Qiuli
authors.initials: Q
authors.lastname: Li
authors.forename: Jin
authors.initials: J
authors.lastname: Guo
authors.forename: Gong
authors.initials: G
authors.lastname: Chen
authors.forename: Weian
authors.initials: W
authors.lastname: Zeng
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects*; D057868:Anastomotic Leak / Q000453:epidemiology* / Q000209:etiology*; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D016896:Treatment Outcome