Risk factors for anastomotic leakage after anterior resection for rectal adenocarcinoma

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Published Jan 30, 2015
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Vol. 92 No. 7 (2014): Issue Jul 2014

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Majbar Mohammed Anass
Elmalki Hadj Omar
Souadka Amine
El Alaoui Mouna
Sabbah Farid
Raiss Mohamed
Hrora Abdelmalek
Ahallat Mohamed

Abstract

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.

Keywords:

Anastomotic leakage; Rectal neoplasm, Adenocarcinoma, Morbidity, Radiotherapy

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