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World Journal of Surgery
Published in: World Journal of Surgery 6/2008

01-06-2008

Risk Factors and Clinical Outcome for Anastomotic Leakage After Total Mesorectal Excision for Rectal Cancer

Authors: Won-Suk Lee, Seong Hyeon Yun, Young-Nam Roh, Hae-Ran Yun, Woo Yong Lee, Yong Beom Cho, Ho-Kyung Chun

Published in: World Journal of Surgery | Issue 6/2008

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Abstract

Background

Anastomosis leakage is a major complication of rectal surgery. The aim of this study was to identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on long-term prognosis and disease-free survival and overall survival in rectal cancer patients.

Methods

Consecutive patients who underwent rectal resection with primary anastomosis below the pelvic peritoneal reflexion for rectal cancer between October 1996 to February 2006 were included.

Results

Anastomosis leakage after LAR occurred in 51 patients (4.0%). The median time to leakage was 4 days (range = 2–30 days). In univariate analysis, gender, level of anastomosis less than 4 cm, preoperative concomitant chemoradiation (CCRT), and length of operation greater than 120 min were significantly associated with anastomosis leakage. In a multivariate analysis, gender (p = 0.041; relative risk = 2.007; 95% CI = 1.030–3.912) and preoperative CCRT (p = 0.003; relative risk = 2.861; 95% CI = 1.417–5.778) were identified as independent prognostic factors. The overall survival of the nonleakage group and the leakage group was 80.2% and 64.9%, respectively (p = 0.170). The 5-year disease-free survival rates were not significantly different between the nonleakage and leakage groups (78.1% vs. 65.9%, p = 0.166).

Conclusions

The incidence of anastomotic leakage after low anterior resection is relatively low. Male gender and preoperative CCRT were associated with increased risk for anastomotic leakage after rectal cancer surgery. No effect of anastomosis leakage on local recurrence was found in this series.
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Metadata
Title
Risk Factors and Clinical Outcome for Anastomotic Leakage After Total Mesorectal Excision for Rectal Cancer
Authors
Won-Suk Lee
Seong Hyeon Yun
Young-Nam Roh
Hae-Ran Yun
Woo Yong Lee
Yong Beom Cho
Ho-Kyung Chun
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 6/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9451-2

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