Anastomotic leakage in rectal cancer patients: a major surgical complication but not a major long-term risk factor

This study investigated the impact of anastomotic leakage, a major surgical complication, on the risk for rectal cancer returning.

The main treatment option for patients with rectal cancer is surgery. One major complication that can occur after surgery is anastomotic leakage. Generally this involves the leakage of fluid at the point where the intestines are reconnected during surgery. It can also involve an abnormal connection forming between the rectum and the vagina or an abscess developing in the pelvis. All of these issues require further surgery or medical care. It is unclear whether anastomotic leakage increases the risk of cancer returning (cancer recurrence). 

The current study examined the impact of anastomotic leakage on survival rates and cancer recurrence. The authors collected medical data from 1181 patients who had curative surgery for rectal cancer. Patients were followed for a total of 5 years to determine the risk of recurrence and death.

9.4% of patients suffered from anastomotic leakage after surgery. The mortality rate was higher (9.9%) in patients with anastomotic leakage following surgery compared to patients without (a 1.6% rate of death following surgery).

Overall, 1153 patients survived the surgery, 100 with anastomotic leakage and 1053 without. Over the 5 year follow-up, anastomotic leakage did not increase the risk of cancer recurrence, death from rectal cancer or death from any other cause. 

The authors concluded that anastomotic leakage does not affect long-term survival or risk of recurrence in patients with rectal cancer.