Controversy still exists concerning the impact of patient and tumor characteristics on anastomotic dehiscence after resection for rectal cancer.
Dr Thomas Eberl and colleagues from Austria prospectively recorded data from 472 patients underwent curative rectal resection.
Patient and tumor characteristics, details of treatment, and postoperative results were evaluated between 1986 and 2006.
Univariate and multivariate analysis were applied to identify risk factors for anastomotic leakage.
The researchers found that the anastomotic leak rate was 10%, and mortality was 2%.
|Patients with low lying rectal tumors are at high risk for anastomotic leakage|
|American Journal of Surgery|
In univariate analysis, tumor diameter and absence of a protective stoma were associated with increased anastomotic leak rate, whereas American Society of Anesthesiologists score and tumor localization showed borderline significance.
In multivariate analysis, tumor diameter, tumor localization, and absence of a protective stoma were significantly associated with anastomotic leakage.
Dr Eberl’s team concluded, “Patients with large and low lying rectal tumors are at high risk for anastomotic leakage.”
“A protective stoma significantly decreases the rate of clinical leaks and subsequent reoperation after low anterior resection.”