World Journal of Surgery

, Volume 35, Issue 12, pp 2806–2810 | Cite as

The Impact of Heavy Smoking on Anastomotic Leakage and Stricture After Low Anterior Resection in Rectal Cancer Patients

  • Min Jung Kim
  • Rumi Shin
  • Heung-Kwon Oh
  • Ji Won Park
  • Seung-Yong Jeong
  • Jae-Gahb Park



Anastomotic complications after low anterior resection are associated with perianastomotic ischemia. Smoking is one of the main causes of microvascular disease that is correlated with tissue ischemia. The purpose of the present study was to assess the impact of smoking on anastomotic complications after low anterior resection in rectal cancer patients.


Between January 2005 and December 2008, 412 patients underwent low anterior resection for rectal cancers by a single surgeon at Seoul National University Hospital. Excluded from this series were 197 patients with postoperative radiation therapy, cancers that were located above 10 cm from the anal verge, or lack of medical records, and the remaining 215 patients were included for analysis. Significant variables in the univariate analysis were subsequently subject to multivariate analysis for identification of risk factors for complications.


The rate of anastomotic complications was 10.7% (23 of 215 patients). Univariate analysis showed that male gender, body mass index higher than 25 kg/m2, smoking history, smoking amount, type of operation, and presence of a protective stoma were associated with anastomotic complications. In multivariate analysis, a history of heavy smoking was a significant risk factor for anastomotic complications.


A history of heavy smoking (more than 40 pack-years) is an independently significant risk factor for anastomotic complications after low anterior resection in rectal cancer patients.


Conflict of interest

The authors declare no conflict of interest or financial tie to disclose.


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Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Min Jung Kim
    • 1
  • Rumi Shin
    • 1
  • Heung-Kwon Oh
    • 1
  • Ji Won Park
    • 2
  • Seung-Yong Jeong
    • 1
  • Jae-Gahb Park
    • 1
  1. 1.Department of SurgerySeoul National University College of MedicineSeoulKorea, Republic of Korea
  2. 2.Center for Colorectal Cancer, Research Institute & Hospital, National Cancer CenterGoyangRepublic of Korea

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