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World Journal of Surgery

, Volume 32, Issue 6, pp 1124–1129 | Cite as

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

  • Won-Suk Lee
  • Seong Hyeon Yun
  • Young-Nam Roh
  • Hae-Ran Yun
  • Woo Yong Lee
  • Yong Beom Cho
  • Ho-Kyung ChunEmail author
Article

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.

Keywords

Rectal Cancer Anastomotic Leakage Leakage Rate Lymphovascular Invasion Rectal Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Won-Suk Lee
    • 1
  • Seong Hyeon Yun
    • 1
  • Young-Nam Roh
    • 1
  • Hae-Ran Yun
    • 1
  • Woo Yong Lee
    • 1
  • Yong Beom Cho
    • 1
  • Ho-Kyung Chun
    • 1
    Email author
  1. 1.Department of SurgerySamsung Medical Center, Sungkyunkwan University School of MedicineGangnam-guKorea

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