Influence of anastomotic leakage in patients prognosis following rectal cancer resection

Objective To investigate the influence of anastomotic leakage following rectal cancer resection to local recurrence and overall survival.Methods From 2004 to 2011,a total of 423 patients with curative rectal cancer resection medical records were reviewed.Diagnosis of leakage was made by clinical features or abdominal CT-scans.Statistically,the Kaplane-Meier survival curve was applied for survival analysis and Log-rank comparison was employed for univariate analysis.Results The average age was 62 years.Median follow-up time was 56.7 months.Anastomotic leakage occurred in 41 patients.Three of these died within 30 days after surgery compared to 6 of the remaining 382 patients without leakage(P0.01).The 5-year overall survival rate was 52.6% in patients with anastomotic leakage compared to 63.5% in those without leakage(P0.01).Excluding 30-day mortality,respective values were 55.3% and 66.7%(P=0.02).Conclusions Although anastomotic failure after colon cancer surgery is rare,it is a very severe complication that not only impairs the perioperative morbidity and mortality but also significantly influences the long-term outcome negatively.