Risk factors for anastomotic leakage following anterior resection for colorectal cancer: the effect of epidural analgesia on occurrence

Abstract

Purpose: The effect of thoracic epidural analgesia (TEA) on anastomotic leakage (AL) after anterior resection for colorectal cancer is controversial. The aim of this study was to evaluate the risk factors including TEA for the occurrence of AL after anterior resection for colorectal cancer.

Methods: This retrospective study included 1,312 patients with colorectal cancer who underwent anterior resection between 2000 and 2011 at the Cancer Center, Sun Yat-sen University. Univariate and multivariate logistics analyses were performed to determine the risk factors, including TEA, for AL. Additionally, we evaluated the effect of TEA on outcome parameters.

Results: AL occurred in 118 (9 %) of the 1,312 patients. In univariate analysis, the American Society of Anesthesiologists (ASA) score, history of hypertension, episodes of hypotension, anastomosis technique, tumor localization, anesthesia duration, and perioperative blood transfusion were significant risk factors for AL. Multivariate analysis showed that ASA (P = 0.001), perioperative blood transfusion (P < 0.001), anastomosis technique (P = 0.019), anesthesia duration (P = 0.033), and tumor localization (P = 0.009) were independent factors affecting AL. TEA had no effect on the occurrence of AL (P = 0.451) in multivariate analysis. However, the length of hospital stay was shortened by the use of TEA (P < 0.001).

Conclusions: The results of this retrospective study suggest that TEA has no effect on the occurrence of AL. However, TEA may be recommended to shorten the length of hospital stay.