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. 2020 Aug 14;18(1):205.
doi: 10.1186/s12957-020-01968-8.

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

Marius Kryzauskas  1 , Augustinas Bausys  1 , Austeja Elzbieta Degutyte  2 , Vilius Abeciunas  3 , Eligijus Poskus  1 , Rimantas Bausys  2 , Audrius Dulskas  2 , Kestutis Strupas  1 , Tomas Poskus  1
Affiliations

Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery

Marius Kryzauskas et al. World J Surg Oncol. .

Abstract

Background: Anastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.

Methods: Nine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified, and long-term outcomes of patients with and without AL were compared.

Results: AL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III-IV; OR = 10.54, p = 0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR = 2.40, p = 0.004), CCI score > 5 (OR = 1.72, p = 0.025), and T3/T4 stage tumors (OR = 2.25, p = 0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p = 0.009 and p = 0.001) and rectal (p = 0.003 and p = 0.014) surgery.

Conclusion: ASA score of III-IV is an independent risk factor for AL after sigmoid surgery, and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.

Keywords: Anastomotic leakage; Colorectal cancer; Disease-free survival; Oncological outcomes; Overall survival; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the patients selection process
Fig. 2
Fig. 2
Overall and disease-free survival in sigmoid and rectal surgery
See this image and copyright information in PMC

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