Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery

Dulk, Marcel den; Marijnen, Corrie A.M.; Collette, Laurence; Putter, Hein; Påhlman, Lars; Folkesson, Joakim; Bosset, J.-F.; Rödel, Claus; Bujko, Krzysztof; Velde, Cornelis J.H. van de

doi:10.1002/bjs.6694

Cited by 251 publications

(138 citation statements)

References 37 publications

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“…По данным мультицентрового анализа, включив-шего данные ведущих исследований (Swedish rectal cancer trial, Dutch TME trial, CAO/ARO/AIO-94 trial, EORTC 22921 trial, Polish rectal cancer trial), частота симптомной несостоятельности колоректального ана-стомоза была статистически выше в группе пациентов без превентивной стомы, чем с ее наличием (11,6 % против 7,8 %; р = 0,002) [16].…”

Section: Discussionunclassified

Short-term results of combined and complex treatment of patients with low rectal cancer

Юдин¹,

Кохнюк²,

Колядич³

2015

Onkol. koloproktol.

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Section: Discussionunclassified

Short-term results of combined and complex treatment of patients with low rectal cancer

Юдин¹,

Кохнюк²,

Колядич³

2015

Onkol. koloproktol.

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“…Regarding this matter, there is a possible protective role of a temporary proximal diverting stoma that may reduce anastomotic leakage [13,14].…”

Section: Discussionmentioning

confidence: 99%

Rectal Cancer - Sphincter Saving Techniques

Russu¹,

Molnar²,

Pantiru³

et al. 2014

Acta Medica Marisiensis

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Background: Rectal cancer management has as its main component the surgical treatment. The purpose of the paper is to point out the advantages and disadvantages of sphincter saving techniques, respecting the oncological principles. Material and method: A cross-sectional, retrospective study was performed on a group of 69 patients admitted and surgically treated for rectal cancers in the Surgical Clinic I of the County Emergency Clinical Hospital of Tîrgu Mureș, for a period of one year (April 2012 -April 2013 and to whom rectal resections were performed. We followed the immediate postoperative evolutions in these patients, making a comparative analysis between those with the sphincter saving surgery and those in which other operations were performed. Results: From the total of 69 patients diagnosed with rectal cancer, sphincter saving procedures with restoration of digestive continuity by coloanal anastomosis were performed in 12 patients (17.39%) using the peranal or transanal approach; in 42 patients (60.86%) anterior rectosigmoidian resections with low and very low colorectal anastomosis ("very low" Dixon procedure) were performed. In 15 cases (21.74%) the Miles type of rectal resections, using the abdomino-perineal way, were performed. Out of the 12 cases with peranal or transanal anastomosis, 4 cases had postoperative complications. Conclusions: Rectal resection procedures, which are restoring the digestive tract continuity using low anastomosis (colorectal, coloanal, peranal or transanal), are representing viable and "physiological" alternatives, if they respect the oncologic principles. In well selected cases, the immediate postoperative evolution is favorable, relieving the patient from the psychological and physical trauma due to the presence of a colostomy.

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“…In addition, it leads to prolonged hospital stay, need for systemic antibiotics, reintervention, and increased overall cost. Oncologically, those who develop anastomotic leakage, particularly those who require reintervention, have been found to have higher incidence of local recurrence and inferior overall survival [6,7]. Functionally, it has been observed that anastomotic leakage carries high probability of permanent stoma [8,9].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Risk Factors and Management of Anastomotic Leakage After Rectal Cancer Surgery: An Indian Series

Jatal

Pai

Demenezes

et al. 2015

Indian J Surg Oncol

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The primary objective of this study was to determine whether sphincter preservation is possible among patients who develop anastomotic leakage after rectal cancer surgery. The secondary objective was to determine the factors that may contribute to anastomotic leakage. This is a retrospective review of a prospectively maintained database. All patients with rectal cancer who underwent restorative proctectomy over 1 year were included in the study. The parameters analyzed were age, preoperative hemoglobin and albumin, neoadjuvant therapy, type of surgery, level of ligation of inferior mesenteric pedicle, technique of anastomosis, and defunctioning proximal stoma. In this study, 176 cases of anterior resection were included,of which15 (8.5 %) had anastomotic leakage. None of the factors contributing to anastomotic leakage reached statistical significance on univariate analysis. Among the patients who had proximal defunctioning ileostomy (n = 9), five (56 %) required re-surgery whereas other four were managed with antibiotics and presacral drainage alone (44 %). Among the patients who didnot have proximal defunctioning ileostomy (n = 6), all (100 %) required re-surgery. Among the 12 eligible patients, stoma reversal was successful in eight (67 %) patients. This study highlights the importance of defunctioning proximal stoma in reducing the incidence and severity of anastomotic leakage as well as the need and extent of re-surgery for low rectal cancer. Sphincter preservation is possible in majority of patients who develop anastomotic leakage after rectal cancer surgery.

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Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery

Cited by 251 publications

References 37 publications

Short-term results of combined and complex treatment of patients with low rectal cancer

Short-term results of combined and complex treatment of patients with low rectal cancer

Rectal Cancer - Sphincter Saving Techniques

Analysis of Risk Factors and Management of Anastomotic Leakage After Rectal Cancer Surgery: An Indian Series

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