ANASTOMOTIC LEAKAGE IN PATIENTS WITH COLORECTAL CANCER

Abstract

Factors related to anastomotic leakage in colorectal surgery were studied in 190 patients with single colorectal cancer. The rate of anastomotic leakage was 5.8% (eleven cases) overall. The highest rate (18.4%) was observed in patients who received low anterior resection. Patients who had more advanced colon cancer tended to have a relatively high rate of anastomotic leakage. Also in the cancer patients with diabetes mellitus or liver cirrhosis there was a higher rate of anastomotic leakage than in patients without these preoperative complication. Preoperative serum cholinesterase and total cholesterol was at a low level in patients with anastomotic leakage. All cases had local peritonitis followed by anastomotic leakage, which closed within about 18 days on the average when treated by total parenteral nutrition (TPN) and complete fasting, except for one reoperated case. TPN maintained the nutritional state of patients with anastomotic leakage. Patients who received low anterior resection in EEA stapler showed no leakage after colorectal anastomosis. These result suggested that EEA stapler is useful for colorectal anastomosis and TPN is effective for anastomotic leakage.