The impact of anastomotic leakage following resection for colorectal cancer is not clear.
In this study, investigators determined whether anastomotic leakage influenced overall and cancer-specific survival.
The team evaluated 2980 consecutive patients undergoing resection between 1971 and 1999.
|The total leak rate was 5%.|
|Annals of Surgery|
They defined total anastomotic leakage as any leak, whether local, general, or radiologically diagnosed.
Patients were followed until death or until 31 December 2002.
Of the initial 2980 patients, 1722 were eligible for inclusion.
The investigators found that the total leak rate was 5%.
The team calculated that the 5-year overall survival rate in patients with a leak was 44%, compared to 64% in patients with no leak.
The team adjusted for age, gender, urgent resection, site, size, stage, grade, venous invasion, apical node metastasis and serosal surface involvement.
They determined that anastomotic leakage had an independent negative association with both overall survival (hazard ratio 1.6) and cancer-specific survival (hazard ratio 1.8).
Dr Kenneth Walker and colleagues concluded, "Apart from its immediate clinical consequences, anastomotic leakage also has an independent negative association with survival".