Risk factors and predictive efficacy of anastomotic fistula after radical right hemicolectomy

Objective To explore the risk factors for the occurrence of anastomotic fistula after radical right hemicolectomy, and to further assess the predictive efficacy of related factors. Methods A total of 467 patients who underwent radical right hemicolectomy for colon cancer at Jiangmen Central Hospital from January 2020 to January 2024 were retrospectively included and grouped according to the occurrence of anastomotic fistula in the postoperative period. Independent risk factors for the occurrence of anastomotic fistula after radical right hemicolonic cancer were analyzed by univariate and multivariate methods, and the predictive efficacy of the various factors on the risk of anastomotic fistula after the surgery was assessed by receiver operating characteristic (ROC) curve. Results Fifty cases of anastomotic fistula occurred after surgery in 467 patients included in this study, with an incidence rate of 10.71%. The results of multifactorial logistic regression analysis showed that the maximum diameter of the tumor＞5 cm, the Nutritional Risk Screening 2002 (NRS2002) score≥3, and the postoperative albumin level＜30 g/L were the independent risk factors for the occurrence of anastomotic fistula after right hemicolectomy (P＜0.05). The ROC curve analysis results showed that the maximum diameter of the tumor, NRS2002 score, postoperative albumin level and the predicted probability of the regression model for the risk of anastomotic fistula after radical right hemicolectomy were 0.63, 0.71, 0.68, 0.88, respectively. Conclusion The occurrence of anastomotic fistula after radical right hemicolectomy may be related to the maximum diameter of the tumor, the NRS2002 score and the postoperative albumin level, and the construction of a regression model based on the above risk factors can accurately predict the risk of postoperative anastomotic fistula.