Abstract
BackgroundAnastomotic leakage (AL) significantly impairs short-term outcomes. The impact on the long-term outcomes remains unclear. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer.MethodsNine-hundred patients with left-sided colorectal carcinoma who underwent sigmoid or rectal resection were enrolled in the study. Risk factors for AL after sigmoid or rectal resection were identified, and long-term outcomes of patients with and without AL were compared.ResultsAL rates following sigmoid and rectal resection were 5.1% and 10.7%, respectively. Higher ASA score (III–IV; OR = 10.54, p = 0.007) was associated with AL in patients undergoing sigmoid surgery on multivariable analysis. Male sex (OR = 2.40, p = 0.004), CCI score > 5 (OR = 1.72, p = 0.025), and T3/T4 stage tumors (OR = 2.25, p = 0.017) were risk factors for AL after rectal resection on multivariable analysis. AL impaired disease-free and overall survival in patients undergoing sigmoid (p = 0.009 and p = 0.001) and rectal (p = 0.003 and p = 0.014) surgery.ConclusionASA score of III–IV is an independent risk factor for AL after sigmoid surgery, and male sex, higher CCI score, and advanced T stage are risk factors for AL after rectal surgery. AL impairs the long-term survival in patients undergoing left-sided colorectal surgery.
Highlights
Anastomotic leakage (AL) is one of the most devastating complications following colorectal resection for left-sided colorectal cancer (CRC) [1]
All patients who underwent elective colorectal resection with primary anastomosis for left-sided CRC were included in the study (Fig. 1)
Patients were divided into sigmoid and rectal surgery sub-groups based on a tumor location
Summary
Anastomotic leakage (AL) is one of the most devastating complications following colorectal resection for left-sided colorectal cancer (CRC) [1]. It leads to increased morbidity, mortality, treatment costs, and prolonged hospitalization. Crippa et al reported similar outcomes in patients with or without AL in Kryzauskas et al World Journal of Surgical Oncology (2020) 18:205 terms of OS, DFS, and local recurrence rates [6]. The present study aimed to determine the impact of AL on the long-term outcomes in patients undergoing surgery for left-sided CRC and to identify the risk factors for AL after sigmoid and rectal resection. This study aimed to identify the risk factors for AL and the impact on long-term survival in patients with left-sided colorectal cancer
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