OBJECTIVE: Anastomotic leakage is a serious complication after anterior resection for rectal carcinoma. It is controversial whether anastomotic leakage influences the rate of locoregional recurrence and therefore survival. PATIENTS AND METHODS: The data of 940 patients with invasive rectal carcinoma stage I-III treated by curative anterior resection from 1978 to 1996 at the Department of Surgery of the University of Erlangen were analysed. Patients who received neoadjuvant or adjuvant treatment were excluded as well as patients who died postoperatively. 89 out of 814 patients (10.9%) developed an anastomotic leakage after anterior resection. RESULTS: The rate of locoregional recurrence during the first five postoperative years of all patients was 13.6%. In patients with anastomotic leakage the rate of locoregional recurrence was 22.0%, significantly higher than in patients without anastomotic leakage which was 12.5%, (P=0.018). On multivariate Cox regression analysis anastomotic leakage was shown to be an independent risk factor for locoregional recurrence (relative risk: 1.7, CI 95%: 1.02-2.75, P=0.042). Also cancer-related survival was influenced significantly by anastomotic leakage in univariate analysis as well as in multivariate analysis (relative risk: 1.6, CI 95%: 1.1-2.2, P=0.017). CONCLUSION: Anastomotic leakage after anterior resection for rectal carcinoma is a risk factor for locoregional recurrence and decreases cancer-related survival.
OBJECTIVE: Anastomotic leakage is a serious complication after anterior resection for rectal carcinoma. It is controversial whether anastomotic leakage influences the rate of locoregional recurrence and therefore survival. PATIENTS AND METHODS: The data of 940 patients with invasive rectal carcinoma stage I-III treated by curative anterior resection from 1978 to 1996 at the Department of Surgery of the University of Erlangen were analysed. Patients who received neoadjuvant or adjuvant treatment were excluded as well as patients who died postoperatively. 89 out of 814 patients (10.9%) developed an anastomotic leakage after anterior resection. RESULTS: The rate of locoregional recurrence during the first five postoperative years of all patients was 13.6%. In patients with anastomotic leakage the rate of locoregional recurrence was 22.0%, significantly higher than in patients without anastomotic leakage which was 12.5%, (P=0.018). On multivariate Cox regression analysis anastomotic leakage was shown to be an independent risk factor for locoregional recurrence (relative risk: 1.7, CI 95%: 1.02-2.75, P=0.042). Also cancer-related survival was influenced significantly by anastomotic leakage in univariate analysis as well as in multivariate analysis (relative risk: 1.6, CI 95%: 1.1-2.2, P=0.017). CONCLUSION: Anastomotic leakage after anterior resection for rectal carcinoma is a risk factor for locoregional recurrence and decreases cancer-related survival.
Authors: Marcus Kiehlmann; Klaus Weber; Jonas Göhl; Rainer Fietkau; Abbas Agaimy; Werner Hohenberger; Susanne Merkel Journal: Int J Colorectal Dis Date: 2015-10-24 Impact factor: 2.571
Authors: Susanne Merkel; Daniela Klossek; Jonas Göhl; Thomas Papadopoulos; Werner Hohenberger; Paul Hermanek Journal: Int J Colorectal Dis Date: 2009-06-02 Impact factor: 2.571
Authors: R E Horch; W Hohenberger; A Eweida; U Kneser; K Weber; A Arkudas; S Merkel; J Göhl; J P Beier Journal: Int J Colorectal Dis Date: 2014-04-22 Impact factor: 2.571
Authors: R Phitayakorn; C P Delaney; H L Reynolds; B J Champagne; A G Heriot; P Neary; A J Senagore Journal: World J Surg Date: 2008-06 Impact factor: 3.352