Long-term outcome after chronic anastomotic leakage following surgery for low rectal cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2022-07-12

AUTHORS

Florian Ponholzer, Clemens Paul Klingler, Elisabeth Gasser, Philipp Gehwolf, Marijana Ninkovic, Ruben Bellotti, Reinhold Kafka-Ritsch, Dietmar Öfner

ABSTRACT

PurposeThis study analyzed the prevalence and factors influencing the history of chronic anastomotic leakage following low anterior resection for rectal cancer. Furthermore, the treatment of a persisting presacral sinus and the impact of stoma reversal on outcome were evaluated.MethodsThe institutional database was scanned for all patients with anastomotic leakage, who were primarily treated for low rectal cancer between January 1995 and December 2019. Patients with rectovaginal and rectovesical fistula or an inadequate follow-up were excluded (n = 5). After applying the exclusion criteria, 71 patients remained for analysis.ResultsA total of 39 patients out of 71 patients with anastomotic leakage (54.9%) developed a persisting presacral sinus. Neoadjuvant radiochemotherapy or chemotherapy showed a significant impact on the formation of a chronic anastomotic leakage (radiochemotherapy: p = 0.034; chemotherapy: p = 0.050), while initial surgical treatment showed no difference for anastomotic healing (p = 0.502), but a significantly better overall survival (p = 0.042). Multiple therapies and surgical revision had a negative impact on patients’ rate of natural bowel continuity (p = 0.006/ < 0.001). In addition, the stoma reversal cohort showed improved overall 10-year survival (p = 0.004) and functional results (bowel continuity: p = 0.026; pain: p = 0.031).ConclusionPrimary surgical therapy for chronic anastomotic leakage should consist of surgical treatment. Furthermore, the reversal of a protective stoma should be considered a viable option in treating chronic presacral sinus to improve pain symptoms and bowel continuity. More... »

PAGES

1807-1816

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00384-022-04213-8

DOI

http://dx.doi.org/10.1007/s00384-022-04213-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1149410561

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35819487


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