[Predictability of anastomotic leaks in visceral surgery].

Chirurgie (Heidelberg, Germany) Pub Date : 2024-11-01 Epub Date: 2024-09-24 DOI:10.1007/s00104-024-02175-x
Jin-On Jung, Georg Dieplinger, Christiane Bruns
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Abstract

Anastomotic leakage in visceral surgery is associated with a large number of known and also unknown or even unmeasurable parameters. Furthermore, the associations between the individual factors are intertwined and complex. According to current data a preoperative prediction is not reliably possible and should be distinguished from intraoperative or postoperative prediction models. Most studies on this topic do not exceed an area under the curve (AUC) of 0.70. A thorough understanding of statistics and prediction models is necessary to correctly interpret the published works. Due to the relatively low incidence rate of anastomotic leakage from a statistical point of view, large datasets are required for adequate prediction. Multimodal data and complex algorithms can potentially handle big data more accurately and improve predictability; however, these models have so far not been applied in the clinical routine.

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[内脏手术吻合口漏的可预测性]。
内脏手术中的吻合口渗漏与大量已知、未知甚至无法测量的参数有关。此外,各个因素之间的关联错综复杂。根据目前的数据,术前预测并不可靠,应区别于术中或术后预测模型。大多数相关研究的曲线下面积(AUC)不超过 0.70。要正确理解已发表的研究成果,必须对统计学和预测模型有透彻的了解。从统计学角度来看,吻合口漏的发生率相对较低,因此需要大量数据集才能进行充分预测。多模态数据和复杂算法有可能更准确地处理大数据并提高预测能力;然而,这些模型至今尚未应用于临床常规。
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