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Diseases of the Colon & Rectum
Published in: Diseases of the Colon & Rectum 8/2008

01-08-2008 | Original Contribution

Neoadjuvant Therapy and Anastomotic Leak After Tumor-Specific Mesorectal Excision for Rectal Cancer

Authors: Guillaume Martel, M.D., Youssuf Al-Suhaibani, M.D., Husein Moloo, M.D., Fatima Haggar, M.P.H., Martin Friedlich, M.D., Joseph Mamazza, M.D., Eric C. Poulin, M.D., Hartley Stern, M.D., Robin P. Boushey, M.D., Ph.D.

Published in: Diseases of the Colon & Rectum | Issue 8/2008

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Abstract

Purpose

This study was designed to evaluate whether neoadjuvant therapy is a risk factor for anastomotic leakage after rectal cancer surgery.

Methods

A retrospective review of 220 patients who underwent tumor-specific mesorectal excision for rectal cancer from 2000 to 2005 was performed. Risk factors for leak were identified by using a multivariable regression model.

Results

A total of 54 patients received neoadjuvant chemoradiation therapy and surgery, whereas 166 received surgery alone. No difference in clinically significant leaks was observed between the two groups (5.6 vs. 6.6 percent, P = 1). A diverting ileostomy was performed in 26.4 percent of patients who received neoadjuvant therapy compared with 9.7 percent for surgery alone (P = 0.0021). Neoadjuvant patients were more likely to have ultralow anastomoses (17.6 vs. 2.5 percent, P < 0.0001). On multivariate analysis, smoking (odds ratio, 6.37 (1.8, 22.2), P = 0.004), difficult anastomosis (odds ratio, 7.66 (1.8, 31.5), P = 0.0048), and low level of anastomosis (≤4 cm from the verge; odds ratio, 5.28 (1.05, 26.6), P = 0.044) were independently associated with anastomotic leakage.

Conclusions

Significant predictors of anastomotic leak include smoking, difficult anastomosis, and level of anastomosis (≤4 cm). Neoadjuvant chemoradiation therapy was not found to be significantly associated with leakage after tumor-specific mesorectal excision for rectal cancer.
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Metadata
Title
Neoadjuvant Therapy and Anastomotic Leak After Tumor-Specific Mesorectal Excision for Rectal Cancer
Authors
Guillaume Martel, M.D.
Youssuf Al-Suhaibani, M.D.
Husein Moloo, M.D.
Fatima Haggar, M.P.H.
Martin Friedlich, M.D.
Joseph Mamazza, M.D.
Eric C. Poulin, M.D.
Hartley Stern, M.D.
Robin P. Boushey, M.D., Ph.D.
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 8/2008
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-008-9368-3

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