This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Anastomotic leakage after curative anterior resection results in a higher prevalence of local recurrence. BJS 2003; 90: 1261-1266.
Published: 12th August 2003
Authors: S. W. Bell, K. G. Walker, M. J. F. X. Rickard, G. Sinclair, O. F. Dent, P. H. Chapuis et al.
Background
The aim of this study was to determine whether leakage from a colorectal anastomosis following potentially curative anterior resection for rectal cancer is an independent risk factor for local recurrence.
Method
The study included all patients who had a potentially curative anterior resection with anastomosis for adenocarcinoma of the rectum between 1971 and 1991 at Concord Hospital. The data were collected prospectively, with complete follow‐up for at least 5 years. The Kaplan–Meier method was used to compare time to recurrence between strata of categorical variables. Proportional hazards regression was used in multivariate modelling.
Results
There were 403 patients in the study. After adjustment for lymph node metastases, the distal resection margin of resection, non‐total anatomical dissection of the rectum and the level of anastomosis, multivariate analysis identified a significant association between anastomotic leakage and local recurrence (hazard ratio 3·8, 95 per cent confidence interval 1·8 to 7·9).
Conclusion
Leakage following a colorectal anastomosis after potentially curative resection for adenocarcinoma of the rectum is an independent predictor of local recurrence. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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