title: Mitigating the Consequences of Anastomotic Leakage After Laparoscopic Rectal Cancer Resection: Is It Achievable by a Simple Method?
abstract: BACKGROUND
  With regard to laparoscopic low anterior resection, anastomotic leakage still remains a challenge and continues to account for approximately 30% of postoperative deaths. This study was designed to evaluate whether the intracolonic and perineal drainage is associated with a decreased risk for anastomotic leakage after laparoscopic rectal cancer surgery without stool diversion.
  
  
  METHODS
  Prospective data were collected from 337 patients with rectal cancer who underwent laparoscopic resection without defunctioning stoma.
  
  
  RESULTS
  A total of 157 patients underwent laparoscopic rectal resection, followed by the placement of intracolonic and perineal drainage, while 180 underwent laparoscopic surgery routinely. No difference in clinically significant leakage was observed between the intracolonic and perineal drainage and the control groups (3.8% vs 8.3%, P = .0874). However, reoperation was underwent at a significantly lower rate after the placement of intracolonic and perineal drainage (intracolonic and perineal drainage: 1 of 6 [16.7%] vs control: 14 of 15 [93.3%]; P < .01). In multivariate analysis, extraperitoneal tumor location and operation duration ≥180 minutes were independently associated with anastomotic leakage.
  
  
  CONCLUSIONS
  Significant risk factors of anastomotic leakage include extraperitoneal tumor location and operation duration ≥180 minutes. The placement of intracolonic and perineal drainage was not found to be significantly associated with anastomotic leakage, but this method could mitigate the clinical consequences of leakage and decrease the rate of reoperation and transverse colostomy after laparoscopic anterior resection for rectal cancer.
authors.affiliation: Affiliated Hospital of Luzhou Medical College, Luzhou, People's Republic of China yangqingqiang121@163.com.
authors.forename: Qingqiang
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Affiliated Hospital of Luzhou Medical College, Luzhou, People's Republic of China.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Tang
authors.affiliation: Affiliated Hospital of Luzhou Medical College, Luzhou, People's Republic of China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Qi
authors.affiliation: Affiliated Hospital of Luzhou Medical College, Luzhou, People's Republic of China.
authors.forename: Guoping
authors.initials: G
authors.lastname: Yi
authors.affiliation: Affiliated Hospital of Luzhou Medical College, Luzhou, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors
keywords: anastomotic leakage; intracolonic and perineal drainage; laparoscopic rectal cancer resection; reoperation