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Risk factors for anastomotic leakage after anterior resection for rectal adenocarcinoma.

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Majbar MA, Elmalki Hadj O, Souadka A, El Alaoui M, Sabbah F, Raiss M, Hrora A, Ahallat M.

 

BACKGROUND: Anastomotic leakage (AL) is an important cause of morbidity after surgery for rectal cancer.

AIM: to analyze the risk factors associated with anastomotic leakage after anterior resection for rectal adenocarcinoma.

METHODS: We collected data from all the patients who had surgical resection with  an anastomosis, for rectal adenocarcinoma at the Surgical Clinic C (Ibn Sina Hospital, Rabat, Morocco), between January 2001 and December 2010. The associations between variables and anastomotic leakage were studied using univariate and multivariate analysis.

RESULTS: Our study included 130 patients. Anastomotic leakage occurred in 28 patients (21.5%). Univariate and multivariate analysis showed that the rate of anastomotic leakage was significantly higher in patients who received preoperative radiotherapy (34.2% vs. 12 %, p = 0.002 – OR 3.8 – CI 95%: 1.5 – 9.4). There was no significant difference in the rate of AL between patients with or without a protective stoma. In the group of patients with AL, the rate of reoperation was significantly lower in patients with a stoma protection (31.8% vs 83.3%, p = 0.04).

CONCLUSION: Radiotherapy is a risk factor for anastomotic leakage. The systematic design of a protective stoma in patients receiving neoadjuvant radiotherapy is advisable to reduce the rate of reoperations associated with AL.

 

PMID: 25775290  [Indexed for MEDLINE]

 

Tunis Med. 2014 Jul;92(7):493-6.

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