Journal of the anus, rectum and colon · 2025
Oncologic Impact of Conservative Treatment Compared with Surgical Treatment of Anastomotic Leakage Following Colorectal Cancer Surgery: A Retrospective Study.
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Sakamoto Junichi, Tsutsui Atsuko, Hagiwara Chie, Wakabayashi Go
Аннотация
OBJECTIVES: Differences in oncological outcomes between conservative and surgical treatments for anastomotic leakage (AL) in patients undergoing colorectal cancer surgery remain unclear.
METHODS: From July 2011 to June 2020, 385 patients underwent curative resection with double-stapling anastomosis for left-sided colon and rectal cancers. Among them, 33 patients who experienced AL were retrospectively evaluated and categorized into two groups: conservative (n = 20) and surgical (n = 13). In the surgical group, abdominal lavage using a sufficient amount of normal saline was performed during reoperation. The primary endpoint was the 3-year cumulative incidence of local recurrence (LR).
RESULTS: Seven (21.2%) patients in the conservative group experienced LR, while none in the surgical group. Survival analysis indicated no differences in overall and recurrent-free survival. However, the 3-year cumulative incidence of LR was significantly lower in the surgical group than in the conservative group (0% versus 31.3%, p=0.045).
CONCLUSIONS: Differences in AL management were associated with oncological outcomes, specifically a decreased LR. Therefore, surgeons should consider our findings when determining the most appropriate AL treatment to improve oncological outcomes.
METHODS: From July 2011 to June 2020, 385 patients underwent curative resection with double-stapling anastomosis for left-sided colon and rectal cancers. Among them, 33 patients who experienced AL were retrospectively evaluated and categorized into two groups: conservative (n = 20) and surgical (n = 13). In the surgical group, abdominal lavage using a sufficient amount of normal saline was performed during reoperation. The primary endpoint was the 3-year cumulative incidence of local recurrence (LR).
RESULTS: Seven (21.2%) patients in the conservative group experienced LR, while none in the surgical group. Survival analysis indicated no differences in overall and recurrent-free survival. However, the 3-year cumulative incidence of LR was significantly lower in the surgical group than in the conservative group (0% versus 31.3%, p=0.045).
CONCLUSIONS: Differences in AL management were associated with oncological outcomes, specifically a decreased LR. Therefore, surgeons should consider our findings when determining the most appropriate AL treatment to improve oncological outcomes.