ArticlePloS one2022
Risk factors and economic burden of postoperative anastomotic leakage related events in patients who underwent surgeries for colorectal cancer.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- The impact of the number of stapler firings on anastomotic leakage in minimally invasive rectal surgery: risk factor or technical marker of complexity? A systematic review, meta‑analysis, and metaregression.Techniques in coloproctology · 2026Pooled it
- Circular powered staplers versus manual staplers in left-sided colorectal anastomoses: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- The economic impact of anastomotic leakage after colorectal surgery: a systematic review.Techniques in coloproctology · 2024Pooled it
- Emergency Surgery and the Risk of Anastomotic Leakage After Colorectal Resection with Primary Anastomosis for Benign and Malignant Disease: A Single-Center Retrospective Study.Journal of clinical medicine · 2026Article
- Risk factor analysis and nomogram model development for anastomotic leakage following laparoscopic radical colorectal cancer surgery.World journal of surgical oncology · 2026Article
- Hospital costs of different treatment strategies for anastomotic leakage after total mesorectal excision: a multicentre cost analysis.Techniques in coloproctology · 2025Article
- The Effect of Albumin/Glutaraldehyde Glue (Bioglue) on Colonic Anastomosis Under Intestinal Obstruction: An Experimental Study in Rats.Journal of clinical medicine · 2025Article
- The impact of anastomotic leakage characteristics on the occurrence of anastomotic stenosis after colorectal resection, a retrospective cohort study.International journal of colorectal disease · 2024Article
- The mesenteric entry site as a potential weak point in gastrointestinal anastomoses - findings from an ex-vivo biomechanical analysis.Langenbeck's archives of surgery · 2024Article
- Perioperative Blood Transfusions and Anastomotic Leak After Colorectal Surgery for Cancer in an Australian Hospital.Journal of gastrointestinal cancer · 2024Article
- Preoperative neutrophil-to-lymphocyte ratio predicts symptomatic anastomotic leakage in elderly colon cancer patients: Multicenter propensity score-matched analysis.World journal of gastrointestinal surgery · 2024Article
- Risk factors of anastomotic leak in colorectal cancer: a multicentric study in a Latin American country.Ecancermedicalscience · 2024Article
- Management of Anastomotic Leakage after Colorectal Resection: Survey among the German CHIR-Net Centers.Journal of clinical medicine · 2023Article
- Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?Current oncology (Toronto, Ont.) · 2023Review
- Clinical analysis of anastomotic fistula after anal preservation in 358 cases of rectal cancer and construction of risk prediction model: a single-center retrospective study.American journal of translational research · 2023Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNationwide research about the clinical and economic burden caused by anastomotic leakage (AL) has not been published yet in Korea. This study assessed the AL rate and quantified the economic burden using the nationwide database.
methodsThis real world evidence study used health claims data provided by the Korean Health Insurance Review and Assessment Service (HIRA, which showed that 156,545 patients underwent anterior resection (AR), low anterior resection (LAR), or ultra-low anterior resection (uLAR) for colorectal cancer (CRC) between January 1, 2007 and January 31, 2020. The incidence of AL was identified using a composite operational definition, a composite of imaging study, antibacterial drug use, reoperation, or image-guided percutaneous drainage. Total hospital costs and length of stay (LOS) were evaluated in patients with AL versus those without AL during index hospitalization and within 30 days after the surgery.
resultsAmong 120,245 patients who met the eligibility criteria, 7,194 (5.98%) patients had AL within 30 days after surgery. Male gender, comorbidities (diabetes, metastatic disease, ischemic heart disease, ischemic stroke), protective ostomy, and multiple linear stapler use, blood transfusion, and urinary tract injury were associated with the higher odds of AL. Older age, rectosigmoid junction cancer, AR, LAR, and laparoscopic approach were related with the reduced odds of AL. Patients with AL incurred higher costs for index hospitalization compared to those without AL (8,991 vs. 7,153 USD; p<0.0001). Patients with AL also required longer LOS (16.78 vs. 14.22 days; p<0.0001) and readmissions (20.83 vs. 13.93 days; p<0.0001).
conclusionAmong patients requiring resection for CRC, the occurrence of AL was associated with significantly increased costs and LOS. Preventing AL could not only produce superior clinical outcomes, but also reduce the economic burden for patients and payers.
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