Premium
Anastomotic leakage after curative anterior resection for rectal cancer: short and long‐term outcome
Author(s) -
Bertelsen C. A.,
Andreasen A. H.,
Jørgensen T.,
Harling H.
Publication year - 2010
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/j.1463-1318.2009.01935.x
Subject(s) - medicine , hazard ratio , colorectal cancer , anastomosis , odds ratio , surgery , proportional hazards model , danish , rectal carcinoma , multivariate analysis , confidence interval , cancer , linguistics , philosophy
Objective The influence of symptomatic anastomotic leakage (AL) after anterior resection (AR) for rectal cancer on short and long‐term mortality and local and distant recurrence was analysed. Method All patients with a first diagnosis of rectal carcinoma were prospectively registered in a national database. This comprised 1494 Danish citizens who had had a curative AR between May 2001 and December 2004. Data on survival and recurrence were obtained from the National Patient Register. Multivariate analyses were performed. Results Anastomotic leakage increased the 30‐day mortality [odds ratio (OR) 4.01 (95% CI 2.24–7.17)]. Of other possible risk factors, only age had a significant interaction with leakage, as the risk of death within 30 days of AR decreased with increasing age. Long‐term survival decreased significantly after AL [hazard ratio (HR) of 1.63, CI 1.21–2.19]. A total of 97 (6.7%) and 258 (18.0%) patients had local and distant recurrence respectively in the follow‐up period. The risk of local and distant recurrence after AL was not different with HR of 1.50 (CI 0.84–2.69) and 1.13 (CI 0.76–1.69) respectively. No other factors influenced the risk of recurrence due to AL. Conclusion Anastomotic leakage after AR for rectal cancer increases the 30‐day and long‐term mortality, but AL did not increase the risk of local and distant recurrence.