title: Risk factors for anastomotic leakage after anterior resection for rectal adenocarcinoma.
abstract: BACKGROUND
  Anastomotic leakage (AL) is an important cause of morbidity after surgery for rectal cancer.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.forename: Mohammed Anass
authors.initials: MA
authors.lastname: Majbar
authors.forename: Omar
authors.initials: O
authors.lastname: Elmalki Hadj
authors.forename: Amine
authors.initials: A
authors.lastname: Souadka
authors.forename: Mouna
authors.initials: M
authors.lastname: El Alaoui
authors.forename: Farid
authors.initials: F
authors.lastname: Sabbah
authors.forename: Mohamed
authors.initials: M
authors.lastname: Raiss
authors.forename: Abdelmalek
authors.initials: A
authors.lastname: Hrora
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ahallat
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000453:epidemiology*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012307:Risk Factors; D055815:Young Adult