Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2470-2481
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2470
Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis
Jun Wang, Min-Hua Li
Jun Wang, Department of Gastrointestinal Surgery, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
Min-Hua Li, Department of Gastroenterology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
Author contributions: Wang J designed the study; Li MH contributed to the analysis of the manuscript; all authors were involved in the data collection and writing of this article; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board at the Affiliated Hospital of Jiangnan University.
Informed consent statement: The authors take full responsibility for the accuracy and integrity of the work. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013), and informed consent was obtained from all patients.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min-Hua Li, RN, Associate Chief Nurse, Department of Gastroenterology, The Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Binhu District, Wuxi 214000, Jiangsu Province, China. huqingtongzhi@163.com
Received: August 15, 2023
Peer-review started: August 15, 2023
First decision: August 31, 2023
Revised: September 5, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 27, 2023
Processing time: 104 Days and 0.2 Hours
Abstract
BACKGROUND

Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically. However, postradical surgery is prone to complications such as anastomotic fistulas.

AIM

To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer.

METHODS

We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery. This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi, Jiangsu Province, China. A t-test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas. Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas. The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery.

RESULTS

Binary logistic regression analysis revealed that age [odds ratio (OR) = 1.043, P = 0.015], tumor, node, metastasis stage (OR = 2.337, P = 0.041), and surgical procedure were independent risk factors for postoperative anastomotic fistulas. Multiple linear regression analysis showed that the development of postoperative anastomotic fistula (P = 0.000), advanced age (P = 0.003), and the presence of diabetes mellitus (P = 0.015), among other factors, independently affected prognosis.

CONCLUSION

Postoperative anastomotic fistulas significantly affect prognosis and survival rates. Therefore, focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

Keywords: Radical colon cancer surgery; Anastomotic fistula; Risk factors; Prognosis; Life expectancy; Survival rate

Core Tip: The incidence of anastomotic fistulas after radical colon cancer surgery is high and significantly affects patient prognosis. Additional targeted interventions should be supplemented to reduce the occurrence of anastomotic fistulas and improve the prognosis.