Factors affecting anastomotic complications following anterior resection in rectal cancer

Abstract

Rectal cancer treated with neo-adjuvant therapy and radical resection with TME for better local control may be associated with greater anastomotic complications particularly when a good pathological response is seen.

Neoadjuvant chemoradiotherapy for rectal carcinoma: effects on anastomotic leak rate and postoperative bladder dysfunction after non-emergency sphincter-preserving anterior rectal resection

“…However, this was predominantly due to an elevated number of perineal wound complications after abdomino-perineal excision while preoperative radiation had no influence on the anastomotic leak rate after anterior resection [16]. Apart from these two multicenter RCTs, most studies dealing with the influence of preoperative therapy on anastomotic leak rate after rectal cancer surgery have been single-center trials including relatively few patients (n=39 through 425) [17][18][19][20][21][22][23][24][25][26][27][28]. Preoperative RT or CRT was not related to anastomotic leak rate in some of these trials while it was an independent risk factor for anastomotic leakage in others.…”

Gold markers for tumor localization and target volume delineation in radiotherapy for rectal cancer

“…The patients' average age was 73 years. All patients underwent preoperative radiochemotherapy and received a total dose of 50.4 Gy (5 × 1.8 Gy/week) and concomitant chemotherapy with 5-FU [13,23]. Eight of them received an additional chemotherapy with concurrent oxaliplatin [19].…”

“…One internationally accepted treatment schedule consists of conventionally fractionated radiotherapy (cumulative dose about 50 Gy) in combination with 5-fluorouracil-(5-FU-)based chemotherapy [7,13,18,20,23]. During the course of a radiotherapy planning the target delineation of rectal tumors is hampered by poor visibility of the tumor on the computed tomography (CT) scans and by tumor motion during the treatment series [4,14].…”

Management postoperativer Komplikationen nach Kolonresektionen

“…Auch eine technisch mangelhaft durchgeführte oder inkomplette Anastomose kann die Ursache einer Nahtinsuffizienz sein [13,14]. Eine vorangegangene Bestrahlungstherapie im Anastomosenbereich stellt ebenfalls einen Risikofaktor für die Entstehung einer Nahtinsuffizienz dar [15] [20,21]. Diese sollte unverzüglich vorgenommen werden.…”