Advanced

Late leakage after anterior resection : a defunctioning stoma alters the clinical course of anastomotic leakage

Jutesten, H. LU ; Draus, J.; Frey, J. LU ; Neovius, G.; Lindmark, G. LU ; Buchwald, P. LU and Lydrup, M. L. LU (2018) In Colorectal Disease 20(2). p.150-159
Abstract

Aim: Anastomotic leakage (AL) is common after anterior resection (AR). Long term clinical outcomes of AL including late presenting leakage (LL) are not well studied. This study was undertaken to assess clinical features of LL with respect to incidence, association with predisposing factors and need for re-intervention. Methods: The Swedish Colorectal Cancer Registry (SCRCR) was explored for AL cases after AR for rectal cancer in patients operated in the south of Sweden from 1 January 2001 to 31 December 2011. Demographic data, surgical technical details, number of postoperative days (POD) until diagnosis of AL, presenting symptoms, methods of diagnosis and treatment were retrieved from medical records. LL was defined according to... (More)

Aim: Anastomotic leakage (AL) is common after anterior resection (AR). Long term clinical outcomes of AL including late presenting leakage (LL) are not well studied. This study was undertaken to assess clinical features of LL with respect to incidence, association with predisposing factors and need for re-intervention. Methods: The Swedish Colorectal Cancer Registry (SCRCR) was explored for AL cases after AR for rectal cancer in patients operated in the south of Sweden from 1 January 2001 to 31 December 2011. Demographic data, surgical technical details, number of postoperative days (POD) until diagnosis of AL, presenting symptoms, methods of diagnosis and treatment were retrieved from medical records. LL was defined according to different cut-offs as leakages occurring after hospital discharge (LLAHD), after 30 POD (LL ≥ POD 30) and after 90 POD (LL ≥ POD 90). Results: In total, 1442 patients were operated on with AR of whom 144 cases of AL (10%) were identified. Median time from operation to follow-up was 87 months (range 21–162). LLAHD, LL ≥ POD 30 and LL ≥ POD 90 were present in 51%, 24% and 9% respectively. All categories of LL were associated with a defunctioning stoma. Relaparotomy was significantly less often employed in LLAHD, but not in other categories of LL. Conclusion: LL constitutes a substantial portion of all AL after AR for rectal cancer. The large proportion of LLAHD calls for awareness in the outpatient setting.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anastomotic leakage, anterior resection, defunctioning stoma, early leakage, late leakage, rectal cancer
in
Colorectal Disease
volume
20
issue
2
pages
10 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85041637068
ISSN
1462-8910
DOI
10.1111/codi.13914
language
English
LU publication?
yes
id
1ae7a237-c93d-4896-8cc0-5d48124be632
date added to LUP
2018-03-06 11:44:13
date last changed
2018-05-29 12:01:57
@article{1ae7a237-c93d-4896-8cc0-5d48124be632,
  abstract     = {<p>Aim: Anastomotic leakage (AL) is common after anterior resection (AR). Long term clinical outcomes of AL including late presenting leakage (LL) are not well studied. This study was undertaken to assess clinical features of LL with respect to incidence, association with predisposing factors and need for re-intervention. Methods: The Swedish Colorectal Cancer Registry (SCRCR) was explored for AL cases after AR for rectal cancer in patients operated in the south of Sweden from 1 January 2001 to 31 December 2011. Demographic data, surgical technical details, number of postoperative days (POD) until diagnosis of AL, presenting symptoms, methods of diagnosis and treatment were retrieved from medical records. LL was defined according to different cut-offs as leakages occurring after hospital discharge (LLAHD), after 30 POD (LL ≥ POD 30) and after 90 POD (LL ≥ POD 90). Results: In total, 1442 patients were operated on with AR of whom 144 cases of AL (10%) were identified. Median time from operation to follow-up was 87 months (range 21–162). LLAHD, LL ≥ POD 30 and LL ≥ POD 90 were present in 51%, 24% and 9% respectively. All categories of LL were associated with a defunctioning stoma. Relaparotomy was significantly less often employed in LLAHD, but not in other categories of LL. Conclusion: LL constitutes a substantial portion of all AL after AR for rectal cancer. The large proportion of LLAHD calls for awareness in the outpatient setting.</p>},
  author       = {Jutesten, H. and Draus, J. and Frey, J. and Neovius, G. and Lindmark, G. and Buchwald, P. and Lydrup, M. L.},
  issn         = {1462-8910},
  keyword      = {Anastomotic leakage,anterior resection,defunctioning stoma,early leakage,late leakage,rectal cancer},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {150--159},
  publisher    = {Wiley-Blackwell},
  series       = {Colorectal Disease},
  title        = {Late leakage after anterior resection : a defunctioning stoma alters the clinical course of anastomotic leakage},
  url          = {http://dx.doi.org/10.1111/codi.13914},
  volume       = {20},
  year         = {2018},
}