Vol 16, No 4 (2022)
Research paper
Published online: 2022-08-30

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Risk of reoperation for anastomotic leakage after anterior resection of rectal cancer after neoadjuvant therapy

Karolina Osowiecka1, Anna Sugajska23, Maciej Biernacki45, Sergiusz Nawrocki23, Monika Rucińska2
Palliat Med Pract 2022;16(4):220-226.


Background: Rectal cancer patients require a multidisciplinary approach. In the case of locally advancedrectal cancer standard treatment includes neoadjuvant radiotherapy or chemoradiotherapy. Neoadjuvanttreatment could cause postoperative complications, but there is no clear evidence of an associationbetween anastomotic leakage and the preoperative treatment of rectal cancer. This study aimed toinvestigate the frequency of anastomotic leakage followed by the need for reoperation and to findpredictive factors for reoperation in rectal cancer patients after neoadjuvant therapy.

Patients and methods: One hundred and ten consecutive patients (median age: 65 years) with locallyadvanced operable rectal cancer, Clinical Stages II and III, were treated with neoadjuvant radiotherapyor chemoradiotherapy (72% were treated with short radiotherapy only, 3% with short radiotherapy andsubsequent chemotherapy, 25% with long radiotherapy plus concomitant chemotherapy) and then anteriorrectal resection with total mesorectal excision in the Regional Oncological Centre between January2014 and December 2016.

Results: The reoperation for anastomotic leakage was done in 17% of patients, 8 days (median) afterprimary surgery. In multivariate analysis reoperation for anastomotic leakage was significantly frequentin older patients (p = 0.03) and upper tumours (p = 0.04).

Conclusions: Almost one-fifth of rectum cancer patients after preoperative radio- or chemoradiotherapyin the present study series required reoperation due to anastomotic leakage. The study findings arelimited by its small sample size and retrospective character.

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