Predictive Factors of Anastomotic Leakage after Resection of Left Colon Cancer: A Single Center Experience

Abstract

Purpose: To evaluate the incidence and the different potential risk factors for the development of anastomotic leakage (AL) after resection of left-sided colon cancer. Also, to evaluate the AL impact on long-term survival outcomes. Methods: We reviewed the cases who underwent surgical resection of left-sided colon cancer during the period between January 2008 and December 2018. Results: 218 cases were included in our study. The commonest presentations were weight loss (45.9%), and bleeding per rectum (40.8%). Left hemi-colectomy was performed in 101 cases (46.3%) and sigmoidectomy in 117 cases (53.7%). The median operation time was 3 hours (1 – 5), and blood loss was 150 ml (50 – 750). Postoperative morbidity occurred in 28 cases (22.1%). AL occurred in 12 cases (5.5%). Early mortality occurred in 6 cases (2.8%). After median follow up of 38 months (15 – 120), mortality occurred in 44 cases (20.2%). The 1, 3-, and 5-years overall survival (OS) were 98.8%, 84.4%, and 64.4%, respectively. Recurrence occurred in 91 cases (41.7%). The 1, 3-, and 5-years disease-free survival (DFS) were 94.9%, 49.1%, and 38%, respectively. We did not find any significant differences between cases with and without AL in terms of OS (p = 0.634) and DFS (p = 0.682). On multivariate analysis, only preoperative serum CEA and operative blood loss were significant predictors for AL. Conclusion: Preoperative serum CEA and operative blood loss were significant predictors for AL. AL did not have a significant impact on the survival outcomes of those cases.