Prognostic Consequences of Anastomotic Leakage in Patients after Laparoscopic Rectal Cancer Resection

Abstract

Introduction: Anastomotic leakage is the horrendous complication after the laparoscopic rectal cancer resection. The main objective of the present study is to assess the relationship between AL, tumor recurrence and overall survival in rectal cancer patients treated with laparoscopic surgery. Methods: One hundred seventy patients who were diagnosed as rectal cancer with stages 1-3 followed by laparoscopic surgery between March 2012 and February 2017 from Beijing Friendship Hospital were evaluated retrospectively. Twelve factors after laparoscopic surgery were evaluated by the univariate analysis and multivariate analysis. The disease-free survival and overall survival curves were performed by the Kaplan- Meier method and were compared with the log-rank test. Results: The incidence rate of AL was 18.82%. The multivariate analysis showed AL [Hazard Ratio (HR); 3.114, 95% Confidence Interval (CI); 1.029-9.428, P; 0.044], advanced TNM stage [HR; 12.714, 95%CI; 2.364-68.377, P; 0.003] and intraoperative blood loss [HR; 0.269, 95%CI; 0.085-0.859, P; 0.027] were associated with poor OS. In addition, AL [Hazard Ratio (HR); 3.134, 95% Confidence Interval (CI); 1.274-7.711, P; 0.013] and advanced TNM stage [HR; 88.378, 95%CI; 2.231-31.465, P; 0.002] were associated with poor DFS. The logrank test p-value for OS and DFS curve by Kaplan-Meier method were 0.382 and 0.108 respectively. Conclusion: Anastomotic leakage was associated with poorer overall survival and increased risk of tumor recurrence. Moreover, there was no difference in three-year/five-year overall survival rate and disease-frees survival rate between the leakage and non-leakage groups in the present analysis.