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International Journal of Colorectal Disease

, Volume 29, Issue 4, pp 459–467 | Cite as

Does anastomotic leakage impair functional results and quality of life after laparoscopic sphincter-saving total mesorectal excision for rectal cancer? A case-matched study

  • Cécile Mongin
  • Léon Maggiori
  • Julie Agostini
  • Marianne Ferron
  • Yves PanisEmail author
Original Article

Abstract

Purpose

Anastomotic leakage (AL) after total mesorectal excision (TME) for rectal cancer is suspected to alter function. However, very few reports have been devoted to this problem. The aim of this study was to assess the influence of AL on function and quality of life (QoL) after laparoscopic TME for cancer.

Methods

A total of 170 patients who underwent laparoscopic TME and sphincter-saving surgery for mid and low rectal cancer were included (67 % after neoadjuvant chemoradiotherapy). Twenty-one patients with AL were assessed for function and QoL (Short Form 36 (SF-36), Fecal Incontinence Quality of Life (FIQL), CR-29, and Wexner’s score) at the most recent follow-up. These patients were matched to 42 patients without AL according to sex, body mass index, ypTNM, radiotherapy, and type of anastomosis.

Results

After a median follow-up of 30 months, AL significantly impaired physical activity (SF-36) (p = 0.004), self-respect (FIQL) (p = 0.029), wear pad’s score (Wexner’s score) (p = 0.043), and blood and mucus in stool score (CR-29) (p = 0.001). Overall Wexner’s score did not show any significant difference in the two groups, 8.9 in AL patients vs. 11.6 in patients without AL (p = 0.1).

Conclusion

AL significantly impairs both functional results and quality of life after laparoscopic sphincter-saving TME for rectal cancer. However, the observed difference was only limited, leading to similar outcomes on most of the tested scores. Patients with AL should be warned that if they initially experience severely impaired results, outcomes tend with time to become similar to those observed in noncomplicated patients.

Keywords

Rectal cancer Laparoscopy Anastomotic leakage Local recurrence Oncologic results 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Cécile Mongin
    • 1
  • Léon Maggiori
    • 1
  • Julie Agostini
    • 1
  • Marianne Ferron
    • 1
  • Yves Panis
    • 1
    Email author
  1. 1.Department of Colorectal Surgery, Pôle des Maladies de l’Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP)University Denis Diderot (Paris VII)ClichyFrance

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