Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114570
Revised: October 12, 2025
Accepted: November 17, 2025
Published online: January 27, 2026
Processing time: 120 Days and 17.9 Hours
Rectal cancer is of particular importance among colorectal malignancies due to technical difficulties in surgical treatment and serious complications that can occur postoperatively.
To determine the probable factors affecting early postoperative complications in patients undergoing low anterior resection (LAR) for rectal cancer.
This retrospective study included adult patients who underwent LAR for rectal cancer between January 1, 2018 and December 31, 2024. The patients were divided into two groups, those with and those without early postoperative complications. Complications developing within the first 30 days after LAR were considered early and complications developing after 30 days were considered late. The level of statistical significance in all statistical evaluations was set as P < 0.05.
A total of 105 patients underwent LAR for rectal cancer, comprising 66 (62.9%) males and 39 (37.1%) females with a mean age of 66 ± 12 years (28-85 years). Protective loop ileostomy was performed in 23 (21.9%) patients. The LAR was performed as open surgery in 63 (60%) patients and laparoscopically in 42 (40%) patients. The mean follow-up period was 46.44 ± 25 months (1-85 months) and the mean disease-free survival duration was 42.49 ± 24 months (1-85 months). Early postoperative complications were observed in 29 (27.6%) patients and late complications were observed in 14 (13.3%) patients. The most frequently seen early postoperative complication was anastomosis leakage in 10 (9.5%) patients. Advanced age, the presence of diabetes mellitus, advanced stage disease, increased preoperative eosinophil/lymphocyte ratio (ELR), and low preoperative albumin and hemoglobin levels were found to be significantly associated with early postoperative complications (P < 0.05). Patients who underwent open LAR surgery were observed to require longer hospitalization and developed more early complications than patients who underwent laparoscopic surgery.
Elevated preoperative ELR in patients undergoing LAR for rectal cancer may predict the development of early postoperative complications. Therefore, further studies are required to be able to establish the importance of the preoperative ELR.
Core Tip: This retrospective study, which included 105 patients with rectal cancer, evaluated the demographic, clinical, and preoperative laboratory data associated with early and late postoperative complications in patients who underwent low anterior resection (LAR) using two different surgical techniques (open and laparoscopic). For the first time, the significance of the preoperative eosinophil/lymphocyte ratio (ELR) on early postoperative complications was evaluated in this study; although this effect was found to be significant in univariate analysis, it was not found to be significant in logistic regression analysis. This result suggests that the relationship between the preoperative ELR and early postoperative complications in rectal cancer patients undergoing LAR should be investigated in prospective, well-designed studies.