Risk factors for clinical anastomotic leakage following the resection of sigmoid and rectal cancer.

ABSTRACT

UNLABELLED The aim of the study was to determine the risk factors for the leakage after sigmoid and rectal cancer resections depending on the height of anastomoses. MATERIAL AND METHODS: Data of 269 patients, who underwent primary resection of colorectal cancer, were analyzed retrospectively 21 patients underwent proctectomy with Parks coloanal anastomosis, 78--low anterior resection of rectum, 67--high anterior resection of rectum and 103--resection of sigmoid colon with colorectal anastomosis. Preoperative radiotherapy was performed on 61 patients. RESULTS: Anastomotic leakage occurred in 20 (7.4%) patients. Multivariate analysis of the overall population showed that the risk of anastomotic leakage was 3.9 times higher for males (p=0.02) and 3.5 times higher for anastomoses situated at or below 10 cm from the anal verge (p=0.01). Multivariate analysis of low colorectal and coloanal anastomoses (n=99) showed that only male sex was an independent factor. Multivariate analysis of patients with anastomosis situated higher than 10 cm from the anal verge (n=170) showed that the preoperative condition of the patient was as independent factor for the development of anastomotic leakage. CONCLUSIONS: Low rectal anastomoses are at risk for anastomotic leakage, especially in males and in generally unfit patients.