title: Nomogram to predict anastomotic leakage after laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique anastomosis for rectal cancer.
abstract: OBJECTIVE
  Laparoscopic rectal cancer surgery involving rectal division with intracorporeal stapling devices is technically difficult. This study aimed to identify risk factors for anastomotic leakage associated with laparoscopic anterior resection for rectal cancer.
  
  
  METHODS
  476 patients who underwent laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique (DST) anastomosis for rectal cancer between July 2007 and February 2013 were retrospectively studied. All clinical variables were examined by univariate and multivariate analyses. A nomogram was developed to predict postoperative anastomotic leakage, given associated risk factors, and bootstrap validation was performed. The outcome of interest was clinical anastomotic leakage.
  
  
  RESULTS
  In multivariate analysis, tumor location (p=0.001), operation time (p=0.001) and preservation of the left colic artery (p=0.037) were independently and significantly associated with anastomotic leakage. The resulting nomogram demonstrated good accuracy in predicting long-term complication, with a bootstrapcorrected concordance index 0.835.
  
  
  CONCLUSIONS
  Our results suggest that we found that tumor localization, preservation of the left colic artery and operation time are predictive factors for clinical anastomotic leakage in laparoscopic anterior resection with intracorporeal rectal transection and double-stapling technique (DST) anastomosis for rectal cancer.
authors.forename: Han Hui
authors.initials: HH
authors.lastname: Yao
authors.forename: Feng
authors.initials: F
authors.lastname: Shao
authors.forename: Qiang
authors.initials: Q
authors.lastname: Huang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Zhi
authors.initials: Z
authors.lastname: Qiang Zhu
authors.forename: Wei
authors.initials: W
authors.lastname: Liang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology*; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049451:Nomograms; D016017:Odds Ratio; D061646:Operative Time; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome