Different clinical features according to the anastomotic leakage subtypes after rectal cancer surgeries

Contained vs. Free leakages

Eun Jung Park, Jeonghyun Kang, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Namkyu Kim

Research output: Contribution to journalArticle

Abstract

Background Anastomotic leakage can be classified by free and contained leakage according to clinical manifestations. The risk factors and their comparison between these leakage subtypes are uncertain. This study aims to evaluate anastomotic leakage patterns and to compare clinical features between free and contained leakages after low anterior resection for rectal cancer. Materials and methods Between January 2005 and December 2012, a total of 2035 consecutive patients who underwent low anterior resection for primary rectal cancer were evaluated retrospectively at two-tertiary referral centers. The primary end points of this study were to assess detailed clinical features among leakage subtypes. The secondary end point was to compare risk factors between free and contained leakages. Results Patients were subdivided into a no leakage group (n = 1890), free leakage group (n = 73), and contained leakage group (n = 72). Free leakage occurred more frequently in laparoscopic and robotic surgeries than open surgery (p = 0.015). On the other hand, contained leakage was developed in a higher rate of patients who received preoperative chemoradiotherapy (p<0.001). The mean development time was 4.6 days in the free leakage group, and 23.6 days in the contained leakage group. Patients with free leakage had a lower rate of a defunctioning stoma than contained leakage (5.5% vs. 29.2%, p<0.001). Risk factors for free leakage were smoking, tumor location, and laparoscopic surgery. However, tumor location and preoperative chemoradiotherapy increased the risk for contained leakage. Conclusions Contained leakage in rectal cancer surgery showed different clinical manifestations and risk factors compared to free leakage. It is necessary to pay more attention to patients with particular risk factors for anastomotic leakage subtypes.

Original languageEnglish
Article numbere0208572
JournalPloS one
Volume13
Issue number12
DOIs
Publication statusPublished - 2018 Dec 1

Fingerprint

Anastomotic Leak
Rectal Neoplasms
colorectal neoplasms
Surgery
risk factors
surgery
Chemoradiotherapy
resection
Laparoscopy
Tumors
laparoscopy
neoplasms
Robotics
Tertiary Care Centers
stomata
Neoplasms
Smoking

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Park, Eun Jung ; Kang, Jeonghyun ; Hur, Hyuk ; Min, Byung Soh ; Baik, Seung Hyuk ; Lee, Kang Young ; Kim, Namkyu. / Different clinical features according to the anastomotic leakage subtypes after rectal cancer surgeries : Contained vs. Free leakages. In: PloS one. 2018 ; Vol. 13, No. 12.
@article{1b00fa7f6f09468087e39d0ceb81e940,
title = "Different clinical features according to the anastomotic leakage subtypes after rectal cancer surgeries: Contained vs. Free leakages",
abstract = "Background Anastomotic leakage can be classified by free and contained leakage according to clinical manifestations. The risk factors and their comparison between these leakage subtypes are uncertain. This study aims to evaluate anastomotic leakage patterns and to compare clinical features between free and contained leakages after low anterior resection for rectal cancer. Materials and methods Between January 2005 and December 2012, a total of 2035 consecutive patients who underwent low anterior resection for primary rectal cancer were evaluated retrospectively at two-tertiary referral centers. The primary end points of this study were to assess detailed clinical features among leakage subtypes. The secondary end point was to compare risk factors between free and contained leakages. Results Patients were subdivided into a no leakage group (n = 1890), free leakage group (n = 73), and contained leakage group (n = 72). Free leakage occurred more frequently in laparoscopic and robotic surgeries than open surgery (p = 0.015). On the other hand, contained leakage was developed in a higher rate of patients who received preoperative chemoradiotherapy (p<0.001). The mean development time was 4.6 days in the free leakage group, and 23.6 days in the contained leakage group. Patients with free leakage had a lower rate of a defunctioning stoma than contained leakage (5.5{\%} vs. 29.2{\%}, p<0.001). Risk factors for free leakage were smoking, tumor location, and laparoscopic surgery. However, tumor location and preoperative chemoradiotherapy increased the risk for contained leakage. Conclusions Contained leakage in rectal cancer surgery showed different clinical manifestations and risk factors compared to free leakage. It is necessary to pay more attention to patients with particular risk factors for anastomotic leakage subtypes.",
author = "Park, {Eun Jung} and Jeonghyun Kang and Hyuk Hur and Min, {Byung Soh} and Baik, {Seung Hyuk} and Lee, {Kang Young} and Namkyu Kim",
year = "2018",
month = "12",
day = "1",
doi = "10.1371/journal.pone.0208572",
language = "English",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

Different clinical features according to the anastomotic leakage subtypes after rectal cancer surgeries : Contained vs. Free leakages. / Park, Eun Jung; Kang, Jeonghyun; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Namkyu.

In: PloS one, Vol. 13, No. 12, e0208572, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Different clinical features according to the anastomotic leakage subtypes after rectal cancer surgeries

T2 - Contained vs. Free leakages

AU - Park, Eun Jung

AU - Kang, Jeonghyun

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Baik, Seung Hyuk

AU - Lee, Kang Young

AU - Kim, Namkyu

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background Anastomotic leakage can be classified by free and contained leakage according to clinical manifestations. The risk factors and their comparison between these leakage subtypes are uncertain. This study aims to evaluate anastomotic leakage patterns and to compare clinical features between free and contained leakages after low anterior resection for rectal cancer. Materials and methods Between January 2005 and December 2012, a total of 2035 consecutive patients who underwent low anterior resection for primary rectal cancer were evaluated retrospectively at two-tertiary referral centers. The primary end points of this study were to assess detailed clinical features among leakage subtypes. The secondary end point was to compare risk factors between free and contained leakages. Results Patients were subdivided into a no leakage group (n = 1890), free leakage group (n = 73), and contained leakage group (n = 72). Free leakage occurred more frequently in laparoscopic and robotic surgeries than open surgery (p = 0.015). On the other hand, contained leakage was developed in a higher rate of patients who received preoperative chemoradiotherapy (p<0.001). The mean development time was 4.6 days in the free leakage group, and 23.6 days in the contained leakage group. Patients with free leakage had a lower rate of a defunctioning stoma than contained leakage (5.5% vs. 29.2%, p<0.001). Risk factors for free leakage were smoking, tumor location, and laparoscopic surgery. However, tumor location and preoperative chemoradiotherapy increased the risk for contained leakage. Conclusions Contained leakage in rectal cancer surgery showed different clinical manifestations and risk factors compared to free leakage. It is necessary to pay more attention to patients with particular risk factors for anastomotic leakage subtypes.

AB - Background Anastomotic leakage can be classified by free and contained leakage according to clinical manifestations. The risk factors and their comparison between these leakage subtypes are uncertain. This study aims to evaluate anastomotic leakage patterns and to compare clinical features between free and contained leakages after low anterior resection for rectal cancer. Materials and methods Between January 2005 and December 2012, a total of 2035 consecutive patients who underwent low anterior resection for primary rectal cancer were evaluated retrospectively at two-tertiary referral centers. The primary end points of this study were to assess detailed clinical features among leakage subtypes. The secondary end point was to compare risk factors between free and contained leakages. Results Patients were subdivided into a no leakage group (n = 1890), free leakage group (n = 73), and contained leakage group (n = 72). Free leakage occurred more frequently in laparoscopic and robotic surgeries than open surgery (p = 0.015). On the other hand, contained leakage was developed in a higher rate of patients who received preoperative chemoradiotherapy (p<0.001). The mean development time was 4.6 days in the free leakage group, and 23.6 days in the contained leakage group. Patients with free leakage had a lower rate of a defunctioning stoma than contained leakage (5.5% vs. 29.2%, p<0.001). Risk factors for free leakage were smoking, tumor location, and laparoscopic surgery. However, tumor location and preoperative chemoradiotherapy increased the risk for contained leakage. Conclusions Contained leakage in rectal cancer surgery showed different clinical manifestations and risk factors compared to free leakage. It is necessary to pay more attention to patients with particular risk factors for anastomotic leakage subtypes.

UR - http://www.scopus.com/inward/record.url?scp=85058482887&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058482887&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0208572

DO - 10.1371/journal.pone.0208572

M3 - Article

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e0208572

ER -