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

Jutesten, Henrik; Draus, John M.; Frey, Jean-Georges; Neovius, G.; Lindmark, Gunilla; Buchwald, Pamela; Lydrup, Marie Louise

doi:10.1111/codi.13914

Cited by 16 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Anastomotic leakage has previously been reported to constitute a major risk factor for permanent stoma after anterior resection ; permanent stoma rates vary from 22% to 56% after symptomatic anastomotic leakage . The relatively high frequency of permanent stoma in our study might in part be related to our long follow‐up time and the high proportion of cases of late leakage in our cohort . Furthermore, differences in therapeutic traditions and attitudes to permanent stoma may have an impact.…”

Section: Discussionmentioning

confidence: 70%

“…A total of 144 anastomotic leakages were identified in 1442 patients who underwent anterior resection for rectal cancer in southern Sweden between 1 January 2001 and 31 December 2011 . Seven laparoscopic anterior resections were undertaken and the rest were open procedures.…”

Section: Resultsmentioning

confidence: 99%

“…The cohort of 139 patients with anastomotic leakage after anterior resection has previously been described in the context of late leakage after anterior resection . Data were collected from medical records on the following: defunctioning stomas, end result of a permanent stoma, type of anastomosis type (end–end, side–end or reservoir), diameter of the circular stapling device, partial or total mesorectal excision, high ligation of inferior mesenteric artery, postoperative date of diagnosis of anastomotic leakage, symptoms at diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…This study evaluates how often a permanent stoma is the long‐term result of treatment for anastomotic leakage after anterior resection for rectal cancer in a regional cohort that was previously described with regard to the relation of a defunctioning stoma to early and late leakages . In addition, this study characterizes risk factors and stoma type in patients with permanent stoma.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer

Jutesten

Draus

Frey³

et al. 2018

Colorectal Disease

Self Cite

View full text Add to dashboard Cite

Aim This study investigates how often bowel continuity was restored after anastomotic leakage in anterior resection for rectal cancer and assesses the clinical factors associated with permanent stoma. Method The Swedish Colorectal Cancer Registry was used to identify cases of anastomotic leakage registered in southern Sweden between January 2001 and December 2011. Patient characteristics, surgical details and clinical information about the anastomotic leakages were retrieved from medical records. Results Of the 1442 patients operated on with anterior resection in 11 hospitals, 144 (10%) were diagnosed with anastomotic leakage after anterior resection for rectal cancer. After a median follow‐up of 87 months (range 21–165), the overall rate of permanent stoma among patients with anastomotic leakage was 65%. Age ≥ 70 years (P = 0.02) and re‐laparotomy (P < 0.001) were independently related to permanent stoma. Compared with nondefunctioned patients with anastomotic leakage, defunctioned patients with anastomotic leakage at the index procedure less often required re‐laparotomy at some point during the entire clinical course (P < 0.001), but nondefunctioned and defunctioned patients with anastomotic leakage both had permanent stoma to the same extent (67% and 62%, respectively). Conclusion Anastomotic leakage is highly associated with permanent stoma after anterior resection, especially in patients aged ≥ 70 years. In this cohort of patients with anastomotic leakage, 65% had permanent stoma at long‐term follow‐up. A defunctioning stoma ameliorates the clinical course but does not affect the end result of bowel continuity in established anastomotic leakage after anterior resection.

show abstract

Section: Discussionmentioning

confidence: 70%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer

Jutesten

Draus

Frey³

et al. 2018

Colorectal Disease

Self Cite

View full text Add to dashboard Cite

show abstract

“…The Swedish ColoRectal Cancer Registry (SCRCR) was explored for cases of AL after AR for rectal cancer in the region of Sk˚ane from 1 January 2001 to 31 December 2011. The cohort was chosen since it is very well characterized and has a long-term follow-up (18,19). In order to identify false-negative registrations, the SCRCR also identified cases of AR subjected to reoperation within 90 days after AR and the regional web-based patient administrative system (PASIS) was explored for all operated patients with rectal cancer with a hospital stay >3 weeks and/or more than readmission within three months after AR.…”

Section: Methodsmentioning

confidence: 99%

Radiological findings in anastomotic leakage after anterior resection may predict a permanent stoma

Jutesten

Lydrup

Landberg

et al. 2020

Acta Radiologica Open

View full text Add to dashboard Cite

Background: Permanent stoma (PS) is common following treatment of anastomotic leakage (AL) after anterior resection (AR) and ways of predicting successful treatment outcome are missing. Purpose: To explore radiological variables in rectal contrast studies in their relation to end-result of PS following treatment for AL after AR. Material and Methods: The Swedish Cancer Registry (SCRCR) was explored for AL cases after AR for rectal cancer in patients operated in the region of Skåne from 1 January 2001 to 31 December 2011. Among identified AL cases, patients subjected to radiological imaging consistent with AL were evaluated according to a predetermined set of radiological variables. Information of PS as the end-result after AL treatment were retrieved from medical records. Results: Thirty-two patients had radiological imaging available for analysis confirming AL after AR; PS rate after a median follow-up of 87 months (range ¼ 21-165) after AR was 62%. Radiological findings compatible with abscess (P ¼ 0.023) and a leak size 6 mm (P ¼ 0.049) were significantly associated with PS. Conclusion: In this limited explorative study, our findings suggest that abscess status and leak size could correspond to outcome of PS in treatment for AL after AR. Additional studies are warranted to further explore this subject.

show abstract

Late anastomotic leakage after anal sphincter saving surgery for rectal cancer: is it different from early anastomotic leakage?

Yang

Han

Cho

et al. 2020

Int J Colorectal Dis

View full text Add to dashboard Cite

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

Abstract: 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.

Cited by 16 publications

References 28 publications

High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer

High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer

Radiological findings in anastomotic leakage after anterior resection may predict a permanent stoma

Late anastomotic leakage after anal sphincter saving surgery for rectal cancer: is it different from early anastomotic leakage?

Contact Info

Product

Resources

About