To identify risk factors of postoperative complications after laparoscopic surgery for middle and lower rectal cancer and to establish a nomogram model in predicting postoperative complications.

Patients who received laparoscopic surgery for middle and lower rectal cancer from January 2018 to October 2019 were enrolled in the present study, clinical data were analyzed. The complications were defined according to the Clavien-Dindo classification, patients with ≥ Level II complications were analyzed for associations in terms of demographic and medical characteristics. By using SPSS 20.0 software, potential risk factors of complications were identified from the characteristics variables per the strength of associations from univariate and multiple logistic regressions, from which nomogram models were subsequently generated. This nomogram model was validated and calibrated by using bootstrap method. The model was also evaluated for clinical significance by using the net benefit curve.

Among 172 middle and lower rectal cancer patients, 54 (31.40%) had postoperative complications within 30 days postoperation. From the adjusted associations with complications, CRP of ≥88.60 mg/L on POD 3 (OR=3.371, P=0.001), advanced age (OR=1.070, P=0.000) and colostomy or ileostomy (OR=3.192, P=0.006), were found independently in predicting postoperative complications. The nomogram comprising the afore mentioned factors displayed good discrimination and predictive consistency.

The nomogram model based on three independent risk factors has good prediction performance for postoperative complications of laparoscopic rectal cancer, which has certain clinical promotion and reference value.