Objective To investigate the influencing factors for the occurrence of anastomotic leakage after laparoscopic radical resection of rectal cancer, and to construct a risk prediction model for anastomotic leakage after laparoscopic radical resection of rectal cancer. Methods Clinical data of 284 patients who underwent laparoscopic radical resection of rectal cancer were retrospectively analyzed. According to whether anastomotic leakage occurred after surgery, these patients were divided into a anastomotic leakage group (n=32) and an non-anastomotic leakage group (n=252). General data and laboratory indicators were compared between the two groups. Multivariate Logistic regression analysis was applied to analyze the influencing factors for the occurrence of anastomotic leakage after laparoscopic radical resection of rectal cancer, and a Logistic regression prediction model was constructed. The receiver operating characteristic curve, calibration curve, and decision curve were plotted to evaluate the predictive performance of the model. Results Among the 284 patients, 32 developed anastomotic leakage after surgery, with an incidence of 11.27%. The proportions of Grade A, Grade B, and Grade C anastomotic leakage were 46.88%, 40.63%, and 12.50% respectively. In the anastomotic leakage group, the proportions of male patients, patients aged ≥ 60 years, patients with a smoking history, and patients with a tumor distance from the anal margin < 7 cm were higher than those in the non-anastomotic leakage group; the body mass index and intraoperative blood loss were also higher than those in the non-anastomotic leakage group. In contrast, the postoperative levels of serum albumin and hemoglobin in the anastomotic leakage group were lower than those in the non-anastomotic leakage group (P<0.05). Results of multivariate Logistic regression analysis showed that male gender, age ≥ 60 years, body mass index, smoking history, and postoperative serum albumin level were influencing factors for the occurrence of anastomotic leakage after laparoscopic radical resection of rectal cancer (P<0.05). The Logistic regression prediction model constructed based on the aforementioned influencing factors has good discriminative ability and calibration ability, and using this model to predict the occurrence of anastomotic leakage after laparoscopic radical resection of rectal cancer can yield favorable clinical benefits. Conclusion Male gender, age ≥ 60 years, body mass index, smoking history, and postoperative serum albumin level are influencing factors for the occurrence of anastomotic leakage after laparoscopic radical resection of rectal cancer. The Logistic regression model constructed based on the aforementioned influencing factors has good predictive performance and application value.

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