Which obesity-associated parameters can better reflect the risk of the occurrence of the anastomotic leakage?

Abstract

Purpose: We investigated which obesity-associated parameters can better predict the risk of anastomotic leakage (AL) in rectal cancer patients that underwent anterior resection of the rectum.

Method: Patients (n = 589) who underwent anterior resection of the rectum with a primary anastomosis were included in this study, including 44 patients with AL and 545 without AL. Univariate analysis was used to compare demographic characteristics and to select risk factors that were used in one-to-one propensity score matching (PSM). Obesity-associated parameters, including preoperative body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), total fat area (TFA), VFA/TFA ratio, serum cholesterol, and triglycerides, were compared between the two groups after PSM.

Results: Sex, neoadjuvant chemotherapy, operation time, and anastomosis level from the anal verge were risk factors for AL (p < .05). After the PSM, BMI, VFA, SFA, TFA, VFA/TFA, and serum cholesterol showed no significant difference between the two group (p > .05). However, the level of serum triglycerides was an independent risk factor for AL (p = .024, odds ratio = 2.95).

Conclusions: Serum triglycerides have potential as a predictive indicator for AL, which may improve the treatment and outcomes of patients with AL.

Keywords:

• Rectal cancer
• anastomotic leakage
• risk factor
• body mass index
• visceral fat area
• serum triglyceride

Disclosure statement

The authors declare that there are no conflicts of interest related to this manuscript.

Author contributions

Zeyang Chen: acquisition of data and drafting of manuscript; Jiejin Yang: measurement of imaging parameters and drafting of manuscript; Zining Liu: design of statistical methods; Yuyang Zhang: acquisition of data; Jiali Sun: measurement of imaging parameters; Pengyuan Wang: critical revision of the manuscript for important intellectual content. There is no conflict of interest in this manuscript.