engleski

Incidence, treatment and outcome of anastomosis dehiscence after surgical procedures for rectal cancer

Introduction: Surgical treatment of rectal cancer has been significantly progressed after appearing of stapling technique in surgery. Thus, formation of hazardous very low anastomosis after anterior rectal resection was enabled. Implementation of mesorectal excision has resulted in lower local tumor recurrence incidence, and at the same time, has increased anastomosis dehiscence rate. Methods: This paper is based on 10-year working experience at Department of Surgery. All data were analyzed retrospectively using the available database. Results: Within the period, from 1990 to 2000, there were 773 patients operated due to primary rectal cancer. Clinically manifested anastomosis dehiscence was detected in 52 (7%) cases. There were 39 (75%) patients with partial anastomosis dehiscence (PAD) and 13 (25%) with total anastomosis dehiscence (TAD). The mean leakage time was seventh post-operative day for both analyzed cases. The time of re-intervention was in range between 1 to 30 and 4 to 26 post-operative day respectively. In PAD group 18 (46%) patients were treated surgically while an emergency surgical procedure was done for all 13 patients in TAD group. The overall mortality was 11 (21%) with the following contribution: 9 (23%) related to PAD and 2 (15%) related to TAD. Discussion: This article considers results of conservative and operative treatment modalities for anastomosis leakage with regard to time of re-intervention as well as risk factors for their development. Details are to be discussed in full paper.

anastomosis dehiscenece; rectal cancer

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