AimThe objective of this study was to find out the effects of anastomotic leakage (AL) following resection of colon cancer upon perioperative outcome and long-term oncological result. Patients and methodsUsing the data base of a country-wide quality assurance study "Quality Assurance in PrimaryColorectal Carcinoma" we analysed the data from the complete sub-population of 844 patients who had AL after resection of colon cancer. These were compared with corresponding data from 27 427 similar patients without AL. Hospital mortality, ALassociated post-operative morbidity and long-term outcome were investigated. ResultsHospital mortality after AL was 18.6%, compared with 2.6% for patients without AI. ALrelated secondary complications occurred in 62.7% cases, while patients without AL had a corresponding rate of 19.9%. Those with AL had a poorer long-term oncological result, with a five-year survival rate of 51.0% (p < 0.001) and a five-year tumour-free survival rate of 63.0% (compare 74.6% without AL; p < 0.001). ConclusionsPost-operative AL after resection of colon cancer is associated with significant morbidity and hospital mortality rates and a greater risk of a poor oncological outcome.

Weight loss following LSG is comparable to RYGB in the short term. Changes in HMW adiponectin are comparable following LSG and RYGB which may further contribute to the successful results after LSG. Furthermore, the results of the present study support the hypothesis that there is an autonomous production of ghrelin in salivary glands irrespective of nutritional status and weight loss.

AimData from the multicentric observation study Kolon/Rektum-Karzinome (Primärtumor) (primary colorectal carcinoma) are adduced to assess the status of surgical treatment of this condition in Germany and to compare different operative approaches in the emergency treatment of obstructive left-sided colon cancer, especially diversion (Hartmann's procedure) and primary anastomosis. Patients and methods Out ResultsIn 57.9% (n = 430) a one-stage operation (Group I), in 11.7% (n = 87) a primary anastomosis with protective stoma (Group II ), and in 30.4% (n = 226), Hartmann's procedure (Group III) was performed. In Group III more patients were male, overweight and multimorbid, and more had advanced-stage tumours. The morbidity and hospital mortality (overall hospital mortality, 7.7%; n = 57) did not differ significantly between the groups. The insertion of a protective stoma did not affect the rate of anastomotic insufficiency (Group I, 7%; Group II, 8.0%). ConclusionsPrimary anastomosis for emergency left-colon carcinoma obstruction should only be regarded as indicated in cases where the risk profile is favourable. Our results suggest that in advanced obstruction and in high-risk cases Hartmann's procedure should be used. A protective stoma did not appear to confer any advantage. Key wordsHartmann's procedure • obstructive left colon cancer • emergency surgery • peri-operative outcome M