Anastomotic leak is not associated with oncologic outcome in patients undergoing low anterior resection for rectal cancer

Annals of Surgery
James D SmithGarrett M Nash

Abstract

To examine the association between anastomotic leak and oncologic outcome after anterior resection, stratifying for defunctioning stoma. It has been hypothesized that anastomotic leak predisposes rectal cancer patients to local recurrence. Many have a defunctioning stoma to reduce risk of clinically significant leakage. The records of patients undergoing low anterior resection (1991-2010) for rectal adenocarcinoma (≤15 cm from anal verge) were retrospectively analyzed using a prospectively collected colorectal database. Data (age, gender, stage, defunctioning stoma, neoadjuvant treatment, distance from anal verge, anastomotic leak) were collected. Clinical leakage was defined as anastomotic complication requiring intervention or interventional radiology within 60 days of surgery. Estimated local recurrence, overall survival, and disease-specific survival were compared using log-rank method and Cox regression analysis. 1127 patients were included, with 5.6-year median follow-up. The incidence of clinical anastomotic leak was 3.5%. Sixteen of 677 with defunctioning stoma (2.2%) developed clinical leak; 24 of 450 without stoma (6.3%) developed leak (P = 0.005). There were no perioperative deaths among patients with clinical leakag...Continue Reading

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Citations

Sep 5, 2013·Annals of Surgical Oncology·Nuh N RahbariMoritz Koch
Jan 27, 2015·The British Journal of Surgery·E EspínUNKNOWN Spanish Rectal Cancer Project
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Apr 13, 2021·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Lucia GraneroJosé Luis Hernández Lizoáin

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