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<p>The association between postoperative abdominal bleeding (POAB) and anastomotic leakage (AL) after colorectal cancer surgery remains unclear, and whether hemostatic therapy would increase AL risk in POAB patients is understudied. We retrospectively analyzed 9651 patients who underwent colorectal resection with anastomosis (2010–2023). Logistic regression models were used to assess the association between POAB and symptomatic AL. In the POAB subgroup, receiver operating characteristic (ROC) curve analysis identified the optimal cutoff for hemostatic agent duration in predicting AL. Symptomatic AL occurred in 348 patients (3.6%). Multivariate analysis showed that POAB (OR 4.311, 95% CI 2.272–8.181; <i>P</i> &lt; 0.001) and tumor location (OR 3.410, 95% CI 2.669–4.358; <i>P</i> &lt; 0.001) were significantly associated with an increased risk of symptomatic AL. POAB occurred in 75 patients (0.78%), of whom 12 developed symptomatic AL. ROC analysis determined 6 days as the optimal hemostatic agent duration cutoff for predicting AL(AUC 0.729, 95% CI: 0.551–0.881; sensitivity 66.7%, specificity 77.8%), and univariate analysis showed that hemostatic agent use for ≥ 6 days was significantly associated with symptomatic AL (<i>P</i> = 0.004). This hypothesis-generating study suggests that POAB was associated with increased risk of symptomatic AL after colorectal cancer surgery and prolonged hemostatic agent use (≥ 6 days) appears to further exacerbate this risk.</p>

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Hemostatic agent use and symptomatic anastomotic leakage in colorectal cancer patients with postoperative abdominal bleeding: a hypothesis-generating study

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Junyu Guo,
  • Mingwei Wei,
  • Houji Guo,
  • Wenpeng Huang

摘要

The association between postoperative abdominal bleeding (POAB) and anastomotic leakage (AL) after colorectal cancer surgery remains unclear, and whether hemostatic therapy would increase AL risk in POAB patients is understudied. We retrospectively analyzed 9651 patients who underwent colorectal resection with anastomosis (2010–2023). Logistic regression models were used to assess the association between POAB and symptomatic AL. In the POAB subgroup, receiver operating characteristic (ROC) curve analysis identified the optimal cutoff for hemostatic agent duration in predicting AL. Symptomatic AL occurred in 348 patients (3.6%). Multivariate analysis showed that POAB (OR 4.311, 95% CI 2.272–8.181; P < 0.001) and tumor location (OR 3.410, 95% CI 2.669–4.358; P < 0.001) were significantly associated with an increased risk of symptomatic AL. POAB occurred in 75 patients (0.78%), of whom 12 developed symptomatic AL. ROC analysis determined 6 days as the optimal hemostatic agent duration cutoff for predicting AL(AUC 0.729, 95% CI: 0.551–0.881; sensitivity 66.7%, specificity 77.8%), and univariate analysis showed that hemostatic agent use for ≥ 6 days was significantly associated with symptomatic AL (P = 0.004). This hypothesis-generating study suggests that POAB was associated with increased risk of symptomatic AL after colorectal cancer surgery and prolonged hemostatic agent use (≥ 6 days) appears to further exacerbate this risk.