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Anastomotic leakage after side‐to‐end anastomosis for rectal cancer: does leakage location matter?
Author(s) -
Hain E.,
Maggiori L.,
Zappa M.,
Prost à la Denise J.,
Panis Y.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14005
Subject(s) - medicine , coloanal anastomosis , total mesorectal excision , anastomosis , colorectal cancer , surgery , asymptomatic , stoma (medicine) , cancer
Aim The aim was to assess outcome according to the location of anastomotic leakage (AL) after side‐to‐end stapler or manual low colorectal or coloanal anastomosis following laparoscopic total mesorectal excision (TME) for rectal cancer. Methods All patients presenting with symptomatic or asymptomatic AL after TME and side‐to‐end low anastomosis for rectal cancer performed from 2005 to 2014 were identified from our prospective database. CT scans with contrast enema were reviewed to assess the location of AL origin. Results Among 279 patients who underwent TME with side‐to‐end anastomosis from 2005 to 2014, 70 patients presented with AL and were included: 43 (61%) patients with AL on the circular anastomosis (CAL) were compared to 27 (39%) with AL on the transverse stapling line of the colonic stump (TAL). CAL and TAL were associated with similar rates of symptomatic AL (63% vs 48%, respectively; P = 0.339), severe postoperative morbidity rates (33% vs 18%; P = 0.313) and long‐term outcomes, including definitive stoma rate (10% vs 11%; P = 0.622) and major low anterior resection syndrome rate (56% vs 57%; P = 0.961). Conclusion Our study showed that whatever the location of AL on a side‐to‐end low colorectal or coloanal anastomosis after TME for cancer, both short‐ and long‐term outcomes are similar.