Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2021; 13(12): 1685-1695
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1685
Risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions
Pei-Pei Wang, Chen Lin, Jiao-Lin Zhou, Kai-Wen Xu, Hui-Zhong Qiu, Bin Wu
Pei-Pei Wang, Chen Lin, Jiao-Lin Zhou, Kai-Wen Xu, Hui-Zhong Qiu, Bin Wu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Wu B designed and revise the review; Wang PP collected clinical data, follow up the patients and wrote the manuscript; Lin C contributed to the analysis and statistics section; Wu B, Zhou JL and Qiu HZ carried out the operation; Xu KW modified the article format; all authors have read and approved the final version to be published.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital.
Informed consent statement: The analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Wu, MD, Chief Doctor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Road, Dongcheng District, Beijing 100730, China. wubin@pumch.cn
Received: July 19, 2021
Peer-review started: July 19, 2021
First decision: September 5, 2021
Revised: September 14, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: December 27, 2021
Abstract
BACKGROUND

The incidence of retrorectal lesions is low, and no consensus has been reached regarding the most optimal surgical approach. Laparoscopic approach has the advantage of minimally invasive. The risk factors influencing perioperative complications of laparoscopic surgery are rarely discussed.

AIM

To investigate the risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions.

METHODS

We retrospectively reviewed the medical records of patients who underwent laparoscopic excision of retrorectal cystic lesions between August 2012 and May 2020 at our hospital. All surgeries were performed in the general surgery department. Patients were divided into groups based on the lesion location and diameter. We analysed the risk factors like type 2 diabetes mellitus, hypertension, the history of abdominal surgery, previous treatment, clinical manifestation, operation duration, blood loss, perioperative complications, and readmission rate within 90 d retrospectively.

RESULTS

Severe perioperative complications occurred in seven patients. Prophylactic transverse colostomy was performed in four patients with suspected rectal injury. Two patients underwent puncture drainage due to postoperative pelvic infection. One patient underwent debridement in the operating room due to incision infection. The massive-lesion group had a significantly longer surgery duration, higher blood loss, higher incidence of perioperative complications, and higher readmission rate within 90 d (P < 0.05). Univariate analysis, multivariate analysis, and logistic regression showed that lesion diameter was an independent risk factor for the development of perioperative complications in patients who underwent laparoscopic excision of retrorectal cystic lesions.

CONCLUSION

The diameter of the lesion is an independent risk factor for perioperative complications in patients who undergo laparoscopic excision of retrorectal cystic lesions. The location of the lesion was not a determining factor of the surgical approach. Laparoscopic surgery is minimally invasive, high-resolution, and flexible, and its use in retrorectal cystic lesions is safe and feasible, also for lesions below the S3 level.

Keywords: Laparoscopic excision, Retrorectal cystic lesions, Minimally invasive, Risk factors, Perioperative complications

Core Tip: The incidence of retrorectal tumors is low, and no consensus has been reached regarding the most optimal surgical approach. Advantages of laparoscopic approach has been demonstrated in this field. We retrospectively reviewed the patients who underwent laparoscopic excision of retrorectal cystic lesions in our center. This study aimed to investigate the risk factors for perioperative complications in laparoscopic surgeries of retrorectal cystic lesions. We also evaluated the feasibility and safety of laparoscopic excision of retrorectal cystic lesions below the S3 Level.