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Surgical Endoscopy
Erschienen in:

10.06.2024

C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging

verfasst von: Tatsunosuke Harada, Masakatsu Numata, Shota Izukawa, Yosuke Atsumi, Keisuke Kazama, Sho Sawazaki, Teni Godai, Hiroyuki Mushiake, Nobuhiro Sugano, Mamoru Uchiyama, Akio Higuchi, Hiroshi Tamagawa, Yusuke Suwa, Jun Watanabe, Tsutomu Sato, Chikara Kunisaki, Aya Saito

Erschienen in: Surgical Endoscopy | Ausgabe 8/2024

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Abstract

Introduction

Indocyanine green fluorescence imaging (ICG-FI) reduces anastomotic leakage (AL) in rectal cancer surgery. However, no studies investigating risk factors for anastomotic leakage specific to the group using ICG-FI have ever previously been conducted. The purpose of this retrospective multicenter study was to ascertain the risk factors for AL in the group using ICG-FI.

Methods

A total of 638 patients who underwent laparoscopic or robotic anterior resection for rectal cancer between April 2018 and March 2023 were included in this study. Patients were divided into two groups: the ICG-FI group (n = 269) and the non-ICG-FI group (n = 369) for comparative analysis. The effects of clinicopathological and treatment-related factors on AL in the ICG-FI group were evaluated using both univariate and multivariate analyses.

Results

The incidence of AL in the ICG-FI group was 4.8%. Although there was no significant difference in the incidence of AL between the two groups, it was observed to be lower in the ICG-FI group. A multivariate analysis revealed a preoperative C-reactive protein-to-albumin ratio (CAR) ≥ 0.049 (odds ratio, 3.73; 95% confidence interval, 1.01–13.70; p = 0.048) as an independent risk factor for AL in the ICG-FI group.

Conclusions

In this study, CAR was the only identified risk factor for AL in the ICG-FI group. It was suggested that CAR could be a criterion for early surgical intervention, prior to the escalation of risks, or for considering interventions such as diverting stoma creation.
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Metadaten
Titel
C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging
verfasst von
Tatsunosuke Harada
Masakatsu Numata
Shota Izukawa
Yosuke Atsumi
Keisuke Kazama
Sho Sawazaki
Teni Godai
Hiroyuki Mushiake
Nobuhiro Sugano
Mamoru Uchiyama
Akio Higuchi
Hiroshi Tamagawa
Yusuke Suwa
Jun Watanabe
Tsutomu Sato
Chikara Kunisaki
Aya Saito
Publikationsdatum
10.06.2024
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 8/2024
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-024-10940-6

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