Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press24710.17650/2220-3478-2018-8-2-18-23ORIGINAL REPORTSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯImpact of anastomotic leakage on outcomes in patients with rectal cancerВлияние несостоятельности анастомоза на онкологические результаты лечения больных раком прямой кишкиhttps://orcid.org/0000-0002-3919-9067RybakovE. G.РыбаковЕ. Г.
Russian Federation

2 Salyama Adilya St., 123423 Moscow

123423 Москва, ул. Саляма Адиля, 2

https://orcid.org/0000-0002-8480-9362ShelyginYu. A.ШелыгинЮ. А.
Russian Federation

2 Salyama Adilya St., 123423 Moscow

123423 Москва, ул. Саляма Адиля, 2

ТаrasoM. A.ТарасовМ. А.
Russian Federation

2 Salyama Adilya St., 123423 Moscow

Михаил Александрович Тарасов 

123423 Москва, ул. Саляма Адиля, 2

tarasov_88@mail.ruhttps://orcid.org/0000-0001-5655-6567АlekseevM. V.АлексеевМ. В.
Russian Federation

2 Salyama Adilya St., 123423 Moscow

123423 Москва, ул. Саляма Адиля, 2

KashnikovV. N.КашниковВ. Н.
Russian Federation

2 Salyama Adilya St., 123423 Moscow

123423 Москва, ул. Саляма Адиля, 2

A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of RussiaФГБУ «Государственный научный центр колопроктологии им. А.Н. Рыжих» Минздрава РоссииRussian Medical Academy of Postgraduate Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России120720188218231207201812072018Copyright ©; 2018, ABV-pressCopyright ©; 2018, АБВ-пресс2018ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/247

Background. The effect of anastomotic leakage (AL) on oncological outcomes after total mesorectumectomy is controversial.

Objective: to investigate the influence of AL and other factors on oncological outcome.

Materials and methods. Data of 67 patients underwent total mesorectumectomy with normal healing were compared with those for 16 patients who experienced AL. Long-term oncological outcomes were analysed.

Results. Median follow-up was 43 months. AL rate was 19.4 % (16 cases out of 83). Following factors had negative influence on lower 4-year disease-free survival rate and reached statistical significance in univariant analysis: tumor invasion (hazard ratio (HR) 8.8; 95 % сonfidence interval (CI) 1.4–13.7; р = 0.01), metastases in regional lymph nodes (HR 3.5; 95 % CI 1.2–12.3; р = 0.03), tumor stage (р = 0.048), level of tumor differentiation (HR 0.1; 95 % CI 0–0.6; р <0.0001), tumor stenosis (HR 8.8; 95 % CI 1.4–13.7; р = 0.002), AL (HR 3.9; 95 % CI 1.6–37.1; р = 0.01). In the logistic regression analysis independent risk factors for the development of recurrence were not revealed.

Conclusion. AL was not proved to be a risk factor of worse oncological outcome. Hence, additional adjuvant treatment or extended follow-up on the basis of the occurrence of AL after low anterior resection of rectal cancer might not be justified.

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