A Novel Predictive Model for Anastomotic Leakage in Colorectal Cancer Using Auto-artificial Intelligence

作者：J. Mazaki, K. Katsumata, Y. Ohno, R. Udo, T. Tago, K. Kasahara, H. Kuwabara, M. Enomoto, T. Ishizaki, Y. Nagakawa, A. Tsuchida · 发表于：Anticancer Research · 年份：2021 · DOI：10.21873/anticanres.15400 · 被引用次数：37 · 研究领域：Medicine

Aim: Anastomotic leakage (AL) in left-sided colorectal cancer is a serious complication, with an incidence rate of 6-18%. We developed a novel predictive model for AL in colorectal surgery with double-stapling technique (DST) anastomosis using auto-artificial intelligence (AI). Patients and Methods: A total of 256 patients who underwent curative surgery for left-sided colorectal cancer between 2017 and 2021 were included. In addition to conventional clinicopathological factors, we included the type of circular stapler using DST, conventional double-row circular stapler (DCS) or EEA™ circular stapler with Tri-Staple™ technology, 28 mm Medium/Thick (Covidien, New Haven, CT, USA) which had triple-row circular stapler (TCS) as a covariate. Auto-AI software Prediction One (Sony Network Communications Inc.) was used to predict AL with 5-fold cross validation. Predictive accuracy was assessed using the area under the receiver operating characteristic curve. Prediction One also evaluated the ‘importance of variables’ (IOV) using a method based on permutation feature importance. Results: The area under the curve of the AI model was 0.766. The type of circular stapler used was the most influential factor contributing to AL (IOV=0.551). Conclusion: This auto-AI predictive model demonstrated an improvement in accuracy compared to the conventional model. It was suggested that use of a TCS may contribute to a reduction in the AL rate.