The Influence Of Anastomotic Leakage On Long-term Survival After Resection For Rectal Cancer

Objective The aim of the study was to analyze the correlation between anastomotic leakage(AL) and long-term survival after resection for rectal cancer.Methods This study is a retrospective analysis of 653 cases of R0 resection surgical treatment for rectal cancer in the department of Colorectal Surgery in Fujian Medical University Union Hospital from January 2007 to December 2011.Results A total of 653 patients underwent curative rectal cancer resections.The total number of patients was 40 with AL,and 613 without AL.5 year disease-free survival, 5 year distant metastasis,5 year local recurrence have no significant difference between patients with and without AL[74.5% vs 78.1%( P =0.808),20.1% vs 14.2%(P =0.965)and 8.4% vs 4.2%(P =0.309)].Multivariate analysis showed AL isn’t an independent factor of 5 year disease-free survival.There are 507 cases needed postoperative adjuvant chemotherapy.AL prolonged the interval between operation and the first time postoperative chemotherapy(38.17±15.404 d vs 29.55±9.824 d, P < 0.001), but only 4 cases exceed 56 d.The rates of the patients finishing postoperative chemotherapy between the two groups were not significant(79.4% vs 76.3%,P = 0.681).Conclusions AL is not an independent predictor of long-term survival for rectal cancer.Actively treating for AL and performing postoperative chemotherapy in time may potentially avoid poor prognosis of AL after resection of rectal cancer.