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Session: ePoster Monitor 3-Colon Cancer 7

eP539 - Management and Outcomes of Anastomotic Leaks After Colorectal Surgery

Monday, June 3, 2024
8:21 AM – 8:26 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Matas Jakubauskas

    Surgeon, fellow
    Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MK

    Marius Kryzauskas, n/a

    Assistant professor
    Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

    Disclosure information not submitted.

  • VA

    Vilius Abeciunas, n/a

    Resident
    Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

    Disclosure information not submitted.

  • AD

    Austeja Elzbieta Degutyte, n/a

    Resident
    Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

    Disclosure information not submitted.

    • Senior Author(s)

  • TP

    Tomas Poskus, n/a

    Professor
    Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

    Disclosure information not submitted.

Purpose/Background: Anastomotic leak (AL) is one of the most feared complications after colorectal surgery. Risk of colonic AL continues to range between 1.5% and 23%. The presentation and management of AL is widely variable and often debatable. Although, this topic is very relevant, original data regarding AL management and patient outcomes is scarce. We aimed to evaluate the management with short- and long-term outcomes of patients that developed AL.Methods/Interventions: We analyzed patients that suffered anastomotic leak after colorectal surgery. We analyzed the AL management techniques (conservative or operative) and whether the patient needed an additional ostomy that was not initially planned. Additionally, we analyzed the mortality and disease progression rates.Results/Outcomes: Throughout the 2014-to-2018-year period a total of 675 patients underwent elective colorectal resection for colorectal cancer. A total of 671 primary anastomosis were formed and 55 (8.2%) of them developed leakage. The median age of the patients that had AL was 70 years (range 31-88), 32 (58.2%) were male and 23 (41.8%) female. Out of 55 leakages, 11 were after right hemicolectomy, 1 after transverse colon resection, 1 after left hemicolectomy, 13 after sigmoid resection, 27 after rectal resection and 2 after subtotal colectomy. Only 7 (12.7%) leaks were managed conservatively or using percutaneous drainage and all the rest of the patients underwent emergency surgery. During reoperation in 44 (91.7%) out of 48 cases an ostomy was formed. Out of the 44 ostomies 16 (36.4%) were end colostomies and 28 (63.6%) were loop ileostomies. The median hospital stay was 21 days (range 4-102) and the mortality rate was 10.9% (6 out of the 55 patients). 3 patients (5.5%) were readmitted within 3 months after discharge. Disease progression was found in 8 patients (16.3%).Conclusion/

Discussion: AL remains a very dangerous complication with high morbidity and mortality rates. The main management remains operative and, in most cases, requiring the formation of an ostomy.