Anastomotic leaks in colorectal cancer surgery: a risk factor for recurrence?

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Abstract
This study examines anastomotic leaks as a potential influence on the long term outcome of patients with colorectal cancer. 167 patients were studied who had clinical and radiological assessment of anastomotic integrity in the post-operative period, following potentially curative resections for left-sided colonic or rectal cancer. There was no evidence of a leak in 135 of these patients, while the remaining 32 developed a clinical and/or a radiological leak. At the end of a mean follow-up of 25 months, 15 patients with leaks (46.9%) developed tumour recurrence, compared with 25 of those without any leak (18.5%; p). Cancer specific mortality at 24 months was also significantly higher for patients with leaks (36.9%±9.7% versus 12.6%±3.3%; ppp<0.001). L'influence de la fuite anastomotique sur l'évolution était indépendante du stade de la tumeur. Ces résultats suggèrent que chez les patients qui subissent une résection chirurgicale pour cancer colo-rectal, l'apparition d'une fuite anastomotique est significativement associée avec une évolution à long terme plus péjorative.