Arterial ligation in anterior resection for rectal cancer: A validation study of the Swedish Colorectal Cancer Registry

Figures & data

Figure 1. Levels of arterial ligation extracted from the registry.

Figure 2. Levels of arterial ligation levels extracted from operative charts. (A) High tie; (B) Low tie; (C) Combination tie.

Table I. Clinical data for 744 patients operated with anterior resection for rectal cancer in Sweden during 2007–2010.

Characteristics	Number (%)
Sex
Male	515 (69.2)
Female	229 (30.8)
Age
< 65	146 (19.6)
65–75	339 (45.6)
> 75	259 (34.8)
ASA class
I–II	498 (68.4)
III–IV	230 (31.6)
Tumour stage
I	208 (28.0)
II	207 (27.8)
III	237 (31.9)
IV	48 (6.5)
Complete pathological response*	7 (0.9)
Unknown	36 (4.9)
Preoperative radiotherapy
None	354 (47.6)
Short	340 (45.7)
Long	50 (6.7)
Type of resection
Total mesorectal excision	481 (64.6)
Partial mesorectal excision	260 (35.0)
Diverting stoma
Yes	538 (72.3)
No	206 (27.7)
Laparoscopic surgery
Yes	40 (6.5)
No	691 (93.5)
Anastomotic leakage
Yes	83 (11.2)
No	661 (88.8)

*Defined as T0N0M0 after radiotherapy.

Table II. Extracted versus registered tie levels in 744 patients operated with anterior resection for rectal cancer in Sweden in 2007–2010.

		Arterial ligation in the registry
		High	Low	Combination	Missing	Total
Arterial ligation in the operative charts	High	233	50	4	4	291
	Low	32	335	5	16	388
	Combination	15	15	12	1	43
	Missing	5	12	1	4	22
	Total	285	412	22	25	744

Table III. Sensitivity, specificity, PPV and NPV with corresponding 95% CI, as well as level of agreement and Cohen's kappa for different levels of tie.

	Reporting characteristics % (95% CI)
Tie variable	Sensitivity	Specificity	PPV	NPV	Agreement	Kappa
Functional high tie	80.2 (75.5–84.4)	90.1 (86.6–92.9)	87.7 (83.5–91.2)	83.8 (79.8–87.2)	85.5	0.71
Functional low tie	90.1 (86.6–92.9)	80.2 (75.5–84.4)	83.8 (79.8–87.2)	87.7 (83.5–91.2)	85.5	0.71
Oncologic high tie	81.2 (76.2–85.5)	88.6 (85.2–91.5)	83.2 (78.3–87.4)	87.2 (83.6–90.2)	85.6	0.70
Oncologic low tie	88.6 (85.2–91.5)	81.2 (76.2–85.5)	87.2 (83.6–90.2)	83.2 (78.3–87.4)	85.6	0.70