MTP6.13 Leaks in malignant colorectal resections: A cohort study

Aims Reported incidence of anastomotic leakage (AL) is < 25 % in colorectal cancer (CRC)-resections. International-Study-Group-of-Rectal-Cancer (ISREC) introduced a grading systems on AL in 2010. AL is believed to have a negative impact on patient’s oncology. Aim of study is to assess management of AL at a single centre. Methods Cohort study was carried out from Jan'2007 to Jan'2025. Descriptive characteristics & post-operative outcomes were evaluated for CRC-resections with AL, non-leaks recruited as controls. Results AL(n=73) Non Leaks(n=1790) Mann Whitney U(p value) Age(yrs) 68.1±1.2 70.4±0.3 NS Sex(M:F) 46:27 982:808 NS ASA(median) 2 2 NS BMI(kg/m2) 26.9±0.7 26.5±0.1 NS Elective(n) 65 1405 NS Laparoscopic(n) 37 1053 NS LN-harvest(n) 16±3.5 17±5.5 NS Leaks Type-A(antibiotics) 32 Type-B(drainage) 11 Type-C(surgery) 30 Days-to-Leak 6 ± 3 Leak-day Day-6 WCC(10x9/L) 14.6±1.9 9.4±0.2 <0.0001 CRP(mg/L) 217.2±13.1 117.1±3.6 <0.0001 Operation-time(mins) 185.8±10.9 176.4±2.1 NS LOS(days) 14±8 8±4 <0.0001 Complications(n) Ileus 16 276 NS HAP 8 188 NS Wound-infections 5 156 NS Collections 36 75 NS Sepsis 15 88 NS 90-D mortality(n) 4 107 NS Survival-rates(%) 1styear 86.8 83.7 5thyear 75.0 60.3 Logrank 10thyear 60.7 47.6 p=NS 15thyear 47.2 37.9 (uncensored) Conclusions AL occurred in 3.9 % of CRC-resections. AL are associated with prolonged rise in WCC & CRP. & prolonged hospitalization. Early radiological-diagnosis & grading is essential. Recognised treatment of type-C leaks remains laparoscopy/laparotomy for source-control with defunctioning-stoma.