Anastomotic leakage after colon cancer surgery: a predictor of significant morbidity and hospital mortality, and diminished tumour-free survival.
OBJECTIVE
The objective of this study was to find out the effects of anastomotic leakage (AL) following resection of colon cancer upon perioperative outcome and long-term oncological result.


METHODS
Using the database of a country-wide quality assurance study "Quality Assurance in Primary Colorectal Carcinoma" we analysed the data from the complete sub-population of 844 patients who had AL after resection of colon cancer. These were compared with corresponding data from 27 427 similar patients without AL. Hospital mortality, AL-associated post-operative morbidity and long-term outcome were investigated.


RESULTS
Hospital mortality after AL was 18.6%, compared with 2.6% for patients without AI. AL-related secondary complications occurred in 62.7% cases, while patients without AL had a corresponding rate of 19.9%. Those with AL had a poorer long-term oncological result, with a five-year survival rate of 51.0% (p<0.001) and a five-year tumour-free survival rate of 63.0% (compare 74.6% without AL; p<0.001).


CONCLUSIONS
Post-operative AL after resection of colon cancer is associated with significant morbidity and hospital mortality rates and with a greater risk of a poor oncological outcome.
Klinik für Allgemein-, Viszeral- und Gefässchirurgie Universitätsklinikum A.ö.R. Magdeburg Leipziger Str. 44 D-39120 Magdeburg, Germany. rainer.kube@gmail.com
R
R
Kube
P
P
Mroczkowski
D
D
Granowski
F
F
Benedix
M
M
Sahm
U
U
Schmidt
I
I
Gastinger
H
H
Lippert
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003106:Colon / Q000601:surgery*; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate