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07 August 2020 : Clinical Research  

Risk Factors for Severe Complications After Laparoscopic Surgery for T3 or T4 Rectal Cancer for Chinese Patients: Experience from a Single Center

Li Chuan Liang1ACE, Dong Liang Liu1B, Shao Jun Liu2C, Lei Hu2F, Yi Ren He2D, Xiao Wan2BF, Liu Liu1AG*, Zhi Qiang Zhu1E

DOI: 10.12659/MSM.920604

Med Sci Monit 2020; 26:e920604

Abstract

BACKGROUND: Patients with rectal cancer are usually at advanced stage with or beyond serosa invasion in China. Severe complications after laparoscopic rectal surgery leads to prolonged hospitalization and high medical cost. This study aimed to explore risk factors for severe complications after laparoscopic surgery of T3 or T4 rectal cancer.

MATERIAL AND METHODS: A total of 287 patients diagnosed with T3 or T4 rectal cancer were enrolled from the Department of Gastrointestinal Surgery of Anhui Provincial Hospital from February 2012 to February 2017. Univariate analysis and multivariable logistic regression model were used to analyze the risk factors for severe complications (Clavien-Dindo grade ≥III) after laparoscopic surgery.

RESULTS: Eighteen patients (6.25%) had severe complications; 15 patients were categorized as Clavien-Dindo grade III, and 3 patients were categorized as Clavien-Dindo grade IV. Univariate analysis showed that male gender, high preoperative white blood cells (WBC), diabetes mellitus, pulmonary dysfunction, and tumor distance from anus were associated with increased risk of severe complications after laparoscopic surgery for rectal cancer. Multivariate analysis showed that preoperative WBC ≥6.9×10⁹/L (OR=5.54 (1.58–19.45), P=0.008), diabetes mellitus (OR=13.07 (3.31–51.67), P=0.000) and pulmonary dysfunction (OR=7.75 (1.69–35.63), P=0.008) were independent risk factors for postoperative severe complications.

CONCLUSIONS: Preoperative high white blood cells, diabetes mellitus and pulmonary dysfunction were independent risk factors for severe complications after laparoscopic surgery for T3 or T4 rectal cancer.

Keywords: Laparoscopes, Postoperative Complications, Rectal Neoplasms, Risk Factors

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Med Sci Monit 2021; 27:e935624

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750