Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2020; 12(10): 425-434
Published online Oct 27, 2020. doi: 10.4240/wjgs.v12.i10.425
Narrow pelvic inlet plane area and obesity as risk factors for anastomotic leakage after intersphincteric resection
Akira Toyoshima, Toshihiro Nishizawa, Eiji Sunami, Ryuji Akai, Takahiro Amano, Akiyoshi Yamashita, Shin Sasaki, Takeshi Endo, Yoshihiro Moriya, Osamu Toyoshima
Akira Toyoshima, Ryuji Akai, Takahiro Amano, Shin Sasaki, Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo 150-8935, Japan
Toshihiro Nishizawa, Department of Gastroenterology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Japan
Toshihiro Nishizawa, Osamu Toyoshima, Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan
Eiji Sunami, Department of Surgery, The University of Kyorin, Tokyo 113-8655, Japan
Akiyoshi Yamashita, Department of Radiology, Japanese Red Cross Medical Center, Tokyo 150-8935, Japan
Takeshi Endo, Tokyo Midtown Clinic, Tokyo 107-6206, Japan
Yoshihiro Moriya, Miki Hospital, Iwate 029-4201, Japan
Author contributions: Toyoshima A is the lead investigator, performed operations, collected and analyzed the data, and wrote the manuscript; Nishizawa T performed the literature search and statistical analysis and wrote the manuscript; Sunami E performed the operations; Akai R and Amano T assisted the operations; Yamashita A drafted the conception; Sasaki S supervised the study and approved the final manuscript; Toyoshima O contributed to data management, interpretation, and revision.
Institutional review board statement: This retrospective study was approved by the ethics review board of the Japanese Red Cross Medical Center on July 31, 2019.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The manuscript was revised according to the STROBE Statement.
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:
Corresponding author: Akira Toyoshima, MD, Doctor, Department of Colorectal Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan.
Received: June 19, 2020
Peer-review started: June 19, 2020
First decision: July 30, 2020
Revised: August 12, 2020
Accepted: September 14, 2020
Article in press: September 14, 2020
Published online: October 27, 2020
Core Tip

Core Tip: Intersphincteric resection (ISR) is the ultimate sphincter-preserving procedure in extremely low rectal cancer. We investigated risk factors for anastomotic leakage after ISR based on clinicopathological variables and pelvimetry. Narrow pelvic inlet and obesity were independent risk factors for anastomotic leakage after ISR. Anastomotic leakage after ISR may be predicted from a narrow pelvic inlet plane area (≤ 10074 mm2).