Risk Factors of Penna et al for Anastomotic Failure Following Transanal Total Mesorectal Excision (TaTME)

Description

Penna et al identified risk factors associated with anastomotic failure following transanal total mesorectal excision (TaTME). These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in the United Kingdom.

Patient selection: transanal total mesorectal excision

Outcome: anastomotic failure (early and late)

Complications:

(1) pelvic abscess

(2) anastomotic fistula

(3) chronic sinus

(4) anastomotic stricture

Risk factors for anastomotic failure used as parameters for a preoperative risk score:

(1) male sex

(2) obesity based on body mass index (BMI)

(3) smoking

(4) diabetes mellitus

(5) tumor > 25 mm in diameter

Additional risk factors from the operation:

(6) excessive intraoperative blood loss (>= 500 mL)

(7) manual anastomosis

(8) prolonged perineal operative time (> 1.5 hours)

Parameter	Finding	Points
sex	female	0
	male	1
body mass index	< 30 kg per sq m	0
	>= 30 kg per square m	1
smoking	no	0
	yes	1
diabetes	no	0
	yes	2
tumor size	<= 25 mm	0
	> 25 mm	1

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

Total Score	Risk Anastomotic Leak
0	6.3%
1	10.7%
2	17.8%
3	23.3%
4	26.2%
5	33.3%
6	50%

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Risk Factors of Penna et al for Anastomotic Failure Following Transanal Total Mesorectal Excision (TaTME)

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