A Predictive Model for Anastomotic Complications After Sphincter-Preserving Surgery for Rectal Cancer: Integrating...

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Pelvic Anatomy

Background:

• Rectal cancer surgery is complex due to pelvic anatomy, increasing postoperative complication risks.
• Anastomotic complications are a significant concern following sphincter-preserving rectal cancer surgery.

Purpose of the Study:

• To evaluate the prognostic significance of clinical and anatomical factors in predicting anastomotic complications.
• To develop a predictive model for anastomotic complications after minimally invasive rectal cancer surgery.

Main Methods:

• Retrospective analysis of 527 rectal cancer patients undergoing robotic or laparoscopic total mesorectal excision.
• Multivariate analysis of preoperative clinical parameters and MRI-derived anatomical measurements.
• Development of a predictive model for postoperative anastomotic complications.

Main Results:

• Anastomotic complications occurred in 15.8% of patients.
• Six predictors identified: tumor-to-anal verge distance, interspinous diameter, clinical N stage, angle α, CEA level, and ASA classification.
• The final model showed an AUC of 0.70, with tumor-to-anal verge distance, interspinous diameter, and clinical N stage as top predictors.

Conclusions:

• Clinical variables and pelvimetry are valuable in predicting anastomotic complications after minimally invasive rectal surgery.
• The developed regression model aids preoperative planning and decision-making.
• Limitations include retrospective design, single-institution data, manual measurements, and 2D analysis.