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  • Title: Risk factors for clinical anastomotic leakage following the resection of sigmoid and rectal cancer.
    Author: Rudinskaite G, Tamelis A, Saladzinskas Z, Pavalkis D.
    Journal: Medicina (Kaunas); 2005; 41(9):741-6. PubMed ID: 16227705.
    Abstract:
    UNLABELLED: 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.
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