Prevention of failure of laparoscopic intracorporeal colorectal anastomosis in rectal cancer surgery

Malignant neoplasms of the rectum represent a complex oncological pathology, and the mortality rate holds one of the leading positions in the structure of cancer mortality. Postoperative complications are often life-threatening and require prolonged treatment and rehabilitation. Objective. To improve the outcomes of surgical treatment for rectal cancer by using a developed modified method for laparoscopic intracorporeal mechanical colorectal anastomosis formation and implementing a developed predictive mathematical model for complication development. Material and methods. The study included 85 patients: Group I consisted of 50 patients who underwent laparoscopic anterior resection of the rectum using the conventional method; Group II included 35 patients who were operated on using the developed technique for intracorporeal colorectal anastomosis formation. Results. In Group I, anastomotic leakage was diagnosed in 8 cases (16%) based on clinical, laboratory, and instrumental examinations. Among these, 5 patients had a preventive stoma, and 3 patients required re-intervention. In Group II, 3 patients (8.5%) were identified with anastomotic insufficiency; they underwent conservative measures with a positive outcome. Assessment of the multivariate analysis results revealed independent risk factors for anastomotic leakage: preoperative hemoglobin level, tumor volume, presence of type 2 diabetes mellitus, and body mass index value. Conclusion. The developed technique for colorectal anastomosis formation and the application of a predictive mathematical model for complication development allows for a two-fold reduction in clinically significant complications related to the colorectal anastomosis.