OBJECTIVE: The influence of symptomatic anastomotic leakage (AL) after anterior resection (AR) for rectal cancer on short and long-term mortality and local and distant recurrence was analysed. METHOD: All patients with a first diagnosis of rectal carcinoma were prospectively registered in a national database. This comprised 1494 Danish citizens who had had a curative AR between May 2001 and December 2004. Data on survival and recurrence were obtained from the National Patient Register. Multivariate analyses were performed. RESULTS: Anastomotic leakage increased the 30-day mortality [odds ratio (OR) 4.01 (95% CI 2.24-7.17)]. Of other possible risk factors, only age had a significant interaction with leakage, as the risk of death within 30 days of AR decreased with increasing age. Long-term survival decreased significantly after AL [hazard ratio (HR) of 1.63, CI 1.21-2.19]. A total of 97 (6.7%) and 258 (18.0%) patients had local and distant recurrence respectively in the follow-up period. The risk of local and distant recurrence after AL was not different with HR of 1.50 (CI 0.84-2.69) and 1.13 (CI 0.76-1.69) respectively. No other factors influenced the risk of recurrence due to AL. CONCLUSION: Anastomotic leakage after AR for rectal cancer increases the 30-day and long-term mortality, but AL did not increase the risk of local and distant recurrence.
OBJECTIVE: The influence of symptomatic anastomotic leakage (AL) after anterior resection (AR) for rectal cancer on short and long-term mortality and local and distant recurrence was analysed. METHOD: All patients with a first diagnosis of rectal carcinoma were prospectively registered in a national database. This comprised 1494 Danish citizens who had had a curative AR between May 2001 and December 2004. Data on survival and recurrence were obtained from the National Patient Register. Multivariate analyses were performed. RESULTS: Anastomotic leakage increased the 30-day mortality [odds ratio (OR) 4.01 (95% CI 2.24-7.17)]. Of other possible risk factors, only age had a significant interaction with leakage, as the risk of death within 30 days of AR decreased with increasing age. Long-term survival decreased significantly after AL [hazard ratio (HR) of 1.63, CI 1.21-2.19]. A total of 97 (6.7%) and 258 (18.0%) patients had local and distant recurrence respectively in the follow-up period. The risk of local and distant recurrence after AL was not different with HR of 1.50 (CI 0.84-2.69) and 1.13 (CI 0.76-1.69) respectively. No other factors influenced the risk of recurrence due to AL. CONCLUSION: Anastomotic leakage after AR for rectal cancer increases the 30-day and long-term mortality, but AL did not increase the risk of local and distant recurrence.
Authors: P Sánchez-Velázquez; M Pera; M Jiménez-Toscano; X Mayol; X Rogés; L Lorente; M Iglesias; M Gallén Journal: Clin Transl Oncol Date: 2018-04-05 Impact factor: 3.405
Authors: Astrid A M Huiberts; Lea M Dijksman; Simone A Boer; Eveline J T Krul; Jan Peringa; Sandra C Donkervoort Journal: Int J Colorectal Dis Date: 2015-04-25 Impact factor: 2.571
Authors: M R Boland; I Reynolds; N McCawley; E Galvin; S El-Masry; J Deasy; D A McNamara Journal: Ann R Coll Surg Engl Date: 2016-09-23 Impact factor: 1.891
Authors: Ulrich Wirth; Susanne Rogers; Kristina Haubensak; Stefan Schopf; Thomas von Ahnen; Hans Martin Schardey Journal: Int J Colorectal Dis Date: 2017-11-08 Impact factor: 2.571