title: Mortality and anastomotic leakage after anterior resection for rectal cancer.
abstract: OBJECTIVE
  The aim of the study was to analyze the mortality and symptomatic anastomotic leak following stapled anastomosis after anterior resection for rectal cancer.
  
  
  METHODS
  We analyzed retrospectively 161 patients subjected to elective anterior resection of the rectum. There were 102 (63.3%) men and 59 (37.7%) women. The patients were divided into two groups according to tumor location: group I - 129 (80.1%) patients with tumor located >6 cm from the anal verge and group II - 32 (19.9%) patients with tumor located =6 cm.
  
  
  RESULTS
  Anastomotic leak was found in 5 (3.1%) patients, three (2.3%) from group I and two (6.2%) from group II (p<0.26). Anastomotic leak was found more often in patients with renal failure (p<0.0023) and in those who had undergone RBC concentrate transfusion (p<0.0045). Seven (4.3%) patients died in the postoperative period. Deaths occurred more frequently in patients with valvular heart disease (p<0.00002), renal failure (p<0.0047) and in those given concentrates of RBC (p<0.045).
  
  
  CONCLUSIONS
  Incidence of postoperative surgical complications after resection for rectal cancer is not high and is acceptable; however, there is an increased risk of leakage after low anterior resection. Renal failure as well as RBC concentrate transfusion have an influence on mortality and anastomotic leak.
authors.affiliation: Department of General and Bariatric Surgery and Emergency Medicine, Medical University of Silesia, Katowice, Poland. jerzy.piecuch@wp.pl
authors.forename: Jerzy
authors.initials: J
authors.lastname: Piecuch
authors.forename: Maciej
authors.initials: M
authors.lastname: Wiewiora
authors.forename: Janusz
authors.initials: J
authors.lastname: Jopek
authors.forename: Monika
authors.initials: M
authors.lastname: Szrot
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Mazur
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zurawinski
authors.forename: Krystyn
authors.initials: K
authors.lastname: Sosada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology* / Q000401:mortality*; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D051437:Renal Insufficiency / Q000150:complications / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects* / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome