Late anastomotic leakage in colorectal surgery: a significant problem

Aim Reported incidence rates of colorectal anastomotic leakage (AL) vary between 2.5 and 20%. There is little information on late anastomotic leakage (LAL). The aim of this study was to determine the incidence of LAL after colorectal resection. Method All patients undergoing colorectal resection wit...

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Bibliographic Details
Published in:Colorectal disease 2013-05, Vol.15 (5), p.e271-e275
Main Authors: Morks, A. N., Ploeg, R. J., Sijbrand Hofker, H., Wiggers, T., Havenga, K.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Anastomotic Leak - etiology
Anastomotic Leak - surgery
anastomotic leakage
Carcinoma - surgery
colon
Colon - surgery
Colorectal Neoplasms - surgery
complication
Endometriosis - surgery
Female
Humans
Low anterior resection
Male
Middle Aged
Ovarian Neoplasms - surgery
rectum
Rectum - surgery
Retrospective Studies
surgery
Time Factors
Young Adult
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Summary:Aim Reported incidence rates of colorectal anastomotic leakage (AL) vary between 2.5 and 20%. There is little information on late anastomotic leakage (LAL). The aim of this study was to determine the incidence of LAL after colorectal resection. Method All patients undergoing colorectal resection with primary anastomosis between January 2004 and October 2009 at the University Medical Center Groningen were included. LAL was defined as anastomotic leakage diagnosed more than 30 days after surgery. Results One hundred and forty‐one patients were analysed. Indications for surgery included both benign and malignant conditions. The incidence of early anastomotic leakage (EAL) within 30 days after surgery was 13%. The LAL rate was 6%. Eighty‐nine per cent of patients with EAL underwent relaparotomy compared with 44% for LAL (P = 0.02). Conclusion One‐third of all anastomotic leakages were diagnosed more than 30 days after surgery. Of these, 44% underwent relaparotomy. Patients with leakage diagnosed within 30 days after surgery were more likely to undergo relaparotomy. LAL is a significant problem after colorectal surgery.
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.12167