Mortality and anastomotic leakage after anterior resection for rectal cancer

Hepatogastroenterology. 2012 May;59(115):721-3. doi: 10.5754/hge09424.

Abstract

Background/aims: The aim of the study was to analyze the mortality and symptomatic anastomotic leak following stapled anastomosis after anterior resection for rectal cancer.

Methodology: We analyzed retrospectively 161 patients subjected to elective anterior resection of the rectum. There were 102 (63.3%) men and 59 (37.7%) women. The patients were divided into two groups according to tumor location: group I - 129 (80.1%) patients with tumor located >6 cm from the anal verge and group II - 32 (19.9%) patients with tumor located =6 cm.

Results: Anastomotic leak was found in 5 (3.1%) patients, three (2.3%) from group I and two (6.2%) from group II (p<0.26). Anastomotic leak was found more often in patients with renal failure (p<0.0023) and in those who had undergone RBC concentrate transfusion (p<0.0045). Seven (4.3%) patients died in the postoperative period. Deaths occurred more frequently in patients with valvular heart disease (p<0.00002), renal failure (p<0.0047) and in those given concentrates of RBC (p<0.045).

Conclusions: Incidence of postoperative surgical complications after resection for rectal cancer is not high and is acceptable; however, there is an increased risk of leakage after low anterior resection. Renal failure as well as RBC concentrate transfusion have an influence on mortality and anastomotic leak.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomotic Leak / etiology*
  • Anastomotic Leak / mortality*
  • Chi-Square Distribution
  • Digestive System Surgical Procedures / adverse effects*
  • Digestive System Surgical Procedures / mortality*
  • Erythrocyte Transfusion / adverse effects
  • Erythrocyte Transfusion / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Poland
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Renal Insufficiency / complications
  • Renal Insufficiency / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Surgical Stapling / adverse effects*
  • Surgical Stapling / mortality*
  • Time Factors
  • Treatment Outcome