Charlson comorbidity index predicts anastomotic leakage in patients with resected right-sided colon cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 5; pp. 804 - 811
• Main Authors: Wada, Hideo, Tominaga, Tetsuro, Nonaka, Takashi, To, Kazuo, Hamada, Kiyoaki, Araki, Masato, Sumida, Yorihisa, Takeshita, Hiroaki, Fukuoka, Hidetoshi, Tanaka, Kenji, Sawai, Terumitsu, Nagayasu, Takeshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.05.2022
• Subjects: Anastomotic Leak - epidemiology; Anastomotic Leak - etiology; Colonic Neoplasms; Comorbidity; Humans; Medicine; Medicine & Public Health; Original Article; Retrospective Studies; Risk Factors; Surgery; Surgical Oncology; Right-sided colon cancer; Charlson comorbidity index; Anastomotic leakage
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02472-0

Purpose Anastomotic leakage after right-sided colon cancer surgery is a serious complication that affects postoperative mortality. The Charlson comorbidity index (CCI) has been reported to be a useful predictor of postoperative complications. Methods A total of 593 cases of right-sided colon cancer resections performed from 2016 to 2020 were examined. The patients were divided into two groups according to the presence or absence of anastomotic leakage (AL, n  = 28; no-AL, n  = 565); clinicopathological and surgical characteristics were compared between the groups. Results The AL group patients had a higher comorbidity rate (96.4% vs. 66.9%, p  < 0.001), higher CCI score ( p  < 0.001), higher blood loss (42 mL vs. 23 mL, p  = 0.046), and longer hospital stay (30 days vs. 12 days, p  < 0.001) than the no-AL group patients. The percentages of chronic pulmonary disease (14.3% vs. 3.9%, p  = 0.029), cerebrovascular disease (14.3% vs. 1.9%, p = 0.022), connective tissue disease (39.3% vs. 3.2%, p  < 0.001), leukemia (3.6% vs. 0%, p  = 0.042), and moderate to severe liver disease (7.1% vs. 0%, p  = 0.002) were significantly higher in the AL group. In the multivariate analysis, CCI ≥ 2 was identified as an independent predictor of postoperative anastomotic leakage (hazard ratio 4.91, 95% confidence interval 2.23–10.85, p  < 0.001). Conclusions CCI could predict anastomotic leakage after right-sided colon cancer surgery.