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Risk Factors and Oncologic Impact of Anastomotic Leakage after Rectal Cancer Surgery

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

The impact of anastomotic leakage on the long-term oncologic outcome is not clear. This retrospective study evaluated risk factors and oncologic impacts of anastomotic leakage after rectal cancer surgery.

Methods

Data were analyzed from 1,391 patients who underwent sphincter preservation for rectal cancer between January 1997 and August 2003. Operations were classified as anterior resection (n = 164), low anterior resection (n = 898), or ultralow anterior resection (n = 329).

Results

The anastomotic leakage rate was 2.5 percent. Multivariate analysis identified male (hazard ratio, 3.03), old age (hazard ratio, 2.42), and lower anastomosis level (hazard ratio, 2.68) as risk factors for leakage. The local recurrence rates were 9.6 and 2.2 percent for the leakage and nonleakage groups, respectively but were not significant (P = 0.14). The overall five-year survival rates were 55.1 and 74.1 percent in the leakage and nonleakage groups, respectively (P < 0.05), and the cancer-specific survival rates were 63 and 78.3 percent in the leakage and nonleakage groups, respectively (P = 0.05). However, in subgroup analysis, significant differences were identified only in Stage III patients.

Conclusions

Age, sex, and ultralow anterior resection were found to be risk factors for anastomotic leakage after rectal cancer surgery. In addition, leakage was associated with poor survival.

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Author information

Authors and Affiliations

  1. Colorectal Clinic, Department of Surgery, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Korea

    Sang Hun Jung M.D., Chang Sik Yu M.D., Pyong Wha Choi M.D., Dae Dong Kim M.D., In Ja Park M.D., Hee Cheol Kim M.D. & Jin Cheon Kim M.D.

  2. Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 388-1, Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea

    Chang Sik Yu M.D.

Authors
  1. Sang Hun Jung M.D.
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  2. Chang Sik Yu M.D.
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Correspondence to Chang Sik Yu M.D..

Additional information

Poster presentation at the meeting of The American Society Colon and Rectal Surgeons, Seattle Washington, June 3 to 7, 2006.

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Jung, S.H., Yu, C.S., Choi, P.W. et al. Risk Factors and Oncologic Impact of Anastomotic Leakage after Rectal Cancer Surgery. Dis Colon Rectum 51, 902–908 (2008). https://doi.org/10.1007/s10350-008-9272-x

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  • DOI: https://doi.org/10.1007/s10350-008-9272-x

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