The aim of the study was to determine the risk factors for the leakage after sigmoid and rectal cancer resections depending on the height of anastomoses.
Material and methods: Data of 269 patients, who underwent primary resection of colorectal cancer, were analyzed retrospectively: 21 patients underwent proctectomy with Parks coloanal anastomosis, 78--low anterior resection of rectum, 67--high anterior resection of rectum and 103--resection of sigmoid colon with colorectal anastomosis. Preoperative radiotherapy was performed on 61 patients.
Results: Anastomotic leakage occurred in 20 (7.4%) patients. Multivariate analysis of the overall population showed that the risk of anastomotic leakage was 3.9 times higher for males (p=0.02) and 3.5 times higher for anastomoses situated at or below 10 cm from the anal verge (p=0.01). Multivariate analysis of low colorectal and coloanal anastomoses (n=99) showed that only male sex was an independent factor. Multivariate analysis of patients with anastomosis situated higher than 10 cm from the anal verge (n=170) showed that the preoperative condition of the patient was as independent factor for the development of anastomotic leakage.
Conclusions: Low rectal anastomoses are at risk for anastomotic leakage, especially in males and in generally unfit patients.