Abstract

Background: Anastomotic leak after rectal cancer surgery is a severe complication associated with poorer oncologic outcome and quality of life. In 2019, the research of A. Azerro with colleagues created a calculation to predict the risk of anastomotic leaking based on preoperative factors, that was called REAL score. However, in Vietnam, no study assessed this method. The aim of this study was the assessment of sensitivity and specificity of a cut off in Rectal Anastomotic Leaked (REAL) score used in each Vietnamese Rectal cancer patient who was undergoing surgery by transabdominal resection method. Besides that, our research also identified all risk factors in a REAL score that were related to the prediction of anastomotic leaking after rectal cancer surgery.

Methods: Cross - sectional descriptive studies were used in our study to 112 rectal cancer patients’records who were operated by transabdominal resection method in Thong Nhat hospital the period from 1/2016 to 12/2021. Wea dded information in each record to REAL score (http://www.real-score.org) and starting assessment.

Results: Thong Nhat Hospital provided individual data on 112 patients. With a threshold value of the receiver operating characteristics (ROC) curve corresponding to 0.3124 in the training set, the area under the ROC curve (AUC) was 0.9537 (p < 0.0001). Sensitivity and specifcity of the model’s probability > 0.3124 to identify anastomotic leak were 100% and 86.67%, respectively. Moreover, our study found out some related risk factors in REAL score to the prediction of anastomotic leaking after rectal cancer surgery, including, interval from Neoadjuvant therapy to surgery, smoking, previous abdominal surgery, ASA, TNM classifcation stage, anastomotic distance and Short Course Radiotherapy.

Conclusions: This calculation based on preoperative risk factors may assist surgeons in decision making. However, there are some difficulties in our study like the limited number of anastomotic leaked patients, and this study just represent patients in Thong Nhat hospital. Therefore, we have to assess this calculation widely in other hospitals in Vietnam.