Anastomotic Leakage Following Low Anterior Resection of Rectal Cancer Considering the Role of Protective Stoma

Background and aims: Probable risk factors of clinical anastomotic leakage and the role of defunctioning stoma in patients undergoing low anterior resection (LAR) for rectal cancer, is still controversial. The goal of our study was to find out possible risk factors of anastomotic leakage and to locate the influence of protective stoma in the rate of anastomotic leakage.

Materials and methods: In this retrospective study, 44 patients underwent LAR with total mesorectal excision (TME) during the period from 2001 to 2006 were analyzed. From these 44 patients 24 were treated with protective stoma while 20 were not.

Results: Overall anastomotic leakage rate was similar among patients with and without protective stoma (odds ratio=0.51, P=0.2357). Male gender, Low anastomosis, Coronery Artery Disease, preoperative radiotherapy, and smoking were great risk factors for developing anastomotic leakage. We did not find any differences between handsewn and stapled anastomosis (odds ratio=0.6).

Conclusion: protective stoma will be helpful depending on surgeon experiences and is not recommended for all the patients routinely. Beside this, male gender, low anastomosis, coronary artery disease, preoperative radiotherapy, and smoking are the major risk factors of anastomotic leakage.