Risk factors for clinical anastomotic leakage following the resection of sigmoid and rectal cancer.
The aim of the study was to determine the risk factors for the leakage after sigmoid and rectal cancer resections depending on the height of anastomoses.


METHODS
Data of 269 patients, who underwent primary resection of colorectal cancer, were analyzed retrospectively: 21 patients underwent proctectomy with Parks coloanal anastomosis, 78--low anterior resection of rectum, 67--high anterior resection of rectum and 103--resection of sigmoid colon with colorectal anastomosis. Preoperative radiotherapy was performed on 61 patients.


RESULTS
Anastomotic leakage occurred in 20 (7.4%) patients. Multivariate analysis of the overall population showed that the risk of anastomotic leakage was 3.9 times higher for males (p=0.02) and 3.5 times higher for anastomoses situated at or below 10 cm from the anal verge (p=0.01). Multivariate analysis of low colorectal and coloanal anastomoses (n=99) showed that only male sex was an independent factor. Multivariate analysis of patients with anastomosis situated higher than 10 cm from the anal verge (n=170) showed that the preoperative condition of the patient was as independent factor for the development of anastomotic leakage.


CONCLUSIONS
Low rectal anastomoses are at risk for anastomotic leakage, especially in males and in generally unfit patients.
Rudinskaite
Giedre
G
Department of Surgery, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Tamelis
Algimantas
A
Saladzinskas
Zilvinas
Z
Pavalkis
Dainius
D
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D003082:Colectomy; D003106:Colon / Q000473:pathology / Q000601:surgery*; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors