Abstract
Introduction Anastomotic leak is one of the serious complications in colorectal cancer surgery. It is associated with reduced 5-year cancer-specific survival, higher recurrence, a source of morbidity and mortality (20 to 23%) with an extra cost to healthcare: £1 million–£3.5 million annually. The purpose of this study was to determine the anastomotic leakage in a high volume centre in the United Kingdom with an established laparoscopic and enhanced recovery programme. Method A retrospective analysis of patients undergoing colorectal cancer resections in our hospital was performed from 2013 to 2014 from a prospectively maintained enhanced recovery database. Anastomotic leak was defined as requiring further clinical intervention (antibiotics +/− radiological drainage +/− surgery) AND confirmed radiologically. Results A total of 187 patients underwent cancer resection with an anastomosis. 103 patients had anterior resections and 84 had hemicolectomies. 157 patients (84%) were laparoscopic resections. 5 (6%) anterior resections leaked and 4 (3.8%) hemicolectomies leaked with an overall leakage of 4.8%. 4 patients who leaked were taken back to theatre (2%) with 1 treated with radiological drainage and 4 treated with antibiotics. Conclusion Leak rates for both anterior resection and other colonic resections are below recommended targets by ACPGBI. Based on this data a safe service can be provided in a high volume centre with a high provision of laparoscopic resections within an enhanced recovery programme. Disclosure of interest None Declared.
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