title: Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis.
abstract: Anastomotic leakage (AL) is one of the most devastating complications after rectal cancer surgery. The double stapling technique has greatly facilitated intestinal reconstruction especially for anastomosis after low anterior resection (LAR). Risk factor analyses for AL after open LAR have been widely reported. However, a few studies have analyzed the risk factors for AL after laparoscopic LAR. Laparoscopic rectal surgery provides an excellent operative field in a narrow pelvic space, and enables total mesorectal excision surgery and preservation of the autonomic nervous system with greater precision. However, rectal transection using a laparoscopic linear stapler is relatively difficult compared with open surgery because of the width and limited performance of the linear stapler. Moreover, laparoscopic LAR exhibits a different postoperative course compared with open LAR, which suggests that the risk factors for AL after laparoscopic LAR may also differ from those after open LAR. In this review, we will discuss the risk factors for AL after laparoscopic LAR.
authors.affiliation: Kenji Kawada, Yoshiharu Sakai, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawada
authors.affiliation: Kenji Kawada, Yoshiharu Sakai, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak / Q000453:epidemiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D059248:Chemoradiotherapy / Q000706:statistics & numerical data*; D003125:Colostomy / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000379:methods; D004322:Drainage; D004358:Drug Therapy / Q000706:statistics & numerical data; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007430:Intraoperative Care; D020360:Neoadjuvant Therapy / Q000706:statistics & numerical data*; D009765:Obesity / Q000453:epidemiology; D061646:Operative Time; D011182:Postoperative Care; D011300:Preoperative Care; D011878:Radiotherapy / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000098:blood supply / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors; D017792:Surgical Stapling / Q000379:methods*; D047368:Tumor Burden
chemical_list: D000900:Anti-Bacterial Agents
keywords: Anastomotic leakage; Laparoscopic low anterior resection; Risk factor