ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Influence of Conversion and Anastomotic Leakage on Survival in Rectal Cancer Surgery; Retrospective Cross-sectional Study.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparison of complications and bowel function among different reconstruction techniques after low anterior resection for rectal cancer: a systematic review and network meta-analysis.World journal of surgical oncology · 2023Pooled it
- Risk factors for anastomotic leakage and long-term outcomes after laparoscopic right colectomy: a multicenter study in a Japanese rural area.Surgery today · 2025Article
- The baseline fecal microbiome differs in patients with and without anastomotic leakage after colorectal cancer surgery.Heliyon · 2024Article
- Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence?Current oncology (Toronto, Ont.) · 2024Review
- Impact of the endoscopic surgical skill qualification system on conversion to laparotomy after low anterior resection for rectal cancer in Japan (a secondary analysis of the EnSSURE study).Surgical endoscopy · 2024Article
- Transverse Coloplasty Pouch versus Straight Coloanal Anastomosis Following Intersphincteric Resection for Low Rectal Cancer: the Functional Benefits May Emerge After Two Years.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery.World journal of gastrointestinal surgery · 2023Review
- Impact of the approach on conversion to open surgery during minimally invasive restorative total mesorectal excision for rectal cancer.International journal of colorectal disease · 2023Article
- Neoadjuvant chemoradiotherapy determines the prognostic impact of anastomotic leakage in advanced rectal cancer.Annals of surgical treatment and research · 2022Article
- The transverse coloplasty pouch is technically easy and safe and improves functional outcomes after low rectal cancer resection-a single center experience with 397 patients.Langenbeck's archives of surgery · 2021Article
- Surgery for Colorectal Cancer: A Trigger for Liver Metastases Development? New Insights into the Underlying Mechanisms.Biomedicines · 2021Review
- Are oncological long-term outcomes equal after laproscopic completed and converted laparoscopic converted rectal resection for cancer?Techniques in coloproctology · 2021Article
- Endo-VAC® customization for sinus/anastomotic-leaks/dehiscence after colorectal anastomosis.Techniques in coloproctology · 2020Article
- Does anastomotic leakage after rectal cancer resection worsen long-term oncologic outcome?International journal of colorectal disease · 2020Article
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Abstract
backgroundConversion and anastomotic leakage in colorectal cancer surgery have been suggested to have a negative impact on long-term oncologic outcomes. The aim of this study in a large Dutch national cohort was to analyze the influence of conversion and anastomotic leakage on long-term oncologic outcome in rectal cancer surgery.
methodsPatients were selected from a retrospective cross-sectional snapshot study. Patients with a benign lesion, distant metastasis, or unknown tumor or metastasis status were excluded. Overall (OS) and disease-free survival (DFS) were compared between laparoscopic, converted, and open surgery as well as between patients with and without anastomotic leakage.
resultsOut of a database of 2095 patients, 638 patients were eligible for inclusion in the laparoscopic, 752 in the open, and 107 in the conversion group. A total of 746 patients met the inclusion criteria and underwent low anterior resection with primary anastomosis, including 106 (14.2%) with anastomotic leakage. OS and DFS were significantly shorter in the conversion compared to the laparoscopic group (p = 0.025 and p = 0.001, respectively) as well as in anastomotic leakage compared to patients without anastomotic leakage (p = 0.002 and p = 0.024, respectively). In multivariable analysis, anastomotic leakage was an independent predictor of OS (hazard ratio 2.167, 95% confidence interval 1.322-3.551) and DFS (1.592, 1077-2.353). Conversion was an independent predictor of DFS (1.525, 1.071-2.172), but not of OS.
conclusionTechnical difficulties during laparoscopic rectal cancer surgery, as reflected by conversion, as well as anastomotic leakage have a negative prognostic impact, underlining the need to improve both aspects in rectal cancer surgery.
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