ArticleAnnals of surgical oncology2025
Risk Factors for and Oncologic Impact of Anastomotic Leakage After Sphincter-Preserving Proctectomy for Mid/Low Rectal Cancer: A Multi-institutional Cohort Study in Japan.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Letter to Editor of Annals of Surgical Oncology Concerning "Risk Factors for and Oncologic Impact of Anastomotic Leakage After Sphincter-Preserving Proctectomy for Mid/Low Rectal Cancer: A Multi-institutional Cohort Study in Japan".Annals of surgical oncology · 2026Article
- Watch-and-wait in rectal cancer: A critical appraisal of promise, perils and unresolved contours of organ preservation (Review).Oncology letters · 2026Review
- Robotic Intracorporeal Single-Stapled Anastomosis (RISS) is Associated with Lower Anastomotic Leakage Rates than the Double-Stapled Technique After Minimally Invasive Total Mesorectal Excision for Rectal Cancer.Annals of surgical oncology · 2026Article
- Indocyanine green fluorescence angiography in laparoscopic sigmoid and rectal cancer surgery: no reduction in anastomotic leakage but a lower incidence of anastomotic strictures. A prospective single-center study.Frontiers in surgery · 2026Article
- Analysis of risk factors for anastomotic fistula in patients after laparoscopic radical resection for rectal cancer.Frontiers in medicine · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic leakage after sphincter-preserving proctectomy is a serious postoperative complication. It is unclear whether diverting ostomy prevents anastomotic leakage, and whether anastomotic leakage worsens long-term oncologic outcomes. PATIENTS AND
methodsData from patients with stage II-III mid/low rectal cancer who underwent sphincter-preserving proctectomy between January 2010 and December 2011 were retrospectively analyzed using a multicenter database from 69 institutions. Factors associated with anastomotic leakage and its influence on oncologic outcomes were evaluated.
resultsA total of 922 patients were included. Anastomotic leakage was diagnosed in 125 patients (13.6%). Anastomotic leakage was associated with increased reoperations (29.6% vs. 1.0%, p < 0.0001), longer hospital stays (median 34 days vs. 15 days, p < 0.0001), and more frequent permanent ostomy (20.8% vs. 11.0%, p = 0.002). Multivariable analysis revealed that absence of diverting ostomy (odds ratio 2.46, 95% confidential interval 1.59-3.85, p = 0.0004) and male sex (odds ratio 2.54, 95% confidence interval 1.58-4.26, p = 0.001) were independently associated with an increased risk of anastomotic leakage. The risk reduction with diverting ostomy was observed in both sexes in interaction term analysis. Anastomotic leakage was associated with an increased risk of local recurrence in patients with pathologic stage III disease (hazard ratio 2.11, 95% confidence interval 1.08-4.14, p = 0.03) but was not associated with overall or recurrence-free survival.
conclusionsAbsence of diverting ostomy and male sex were risk factors for anastomotic leakage, and anastomotic leakage was associated with increased local recurrence in patients with stage III disease. These findings support the practice of protective diversion after sphincter-preserving proctectomy in patients with mid/low rectal cancer.
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