Surgery, Gastroenterology and Oncology

Background: Anastomotic leakage (AL) after colorectal resections is a common surgical experience and the most frequent major adverse outcome. Early recognition of AL is critical to reduce mortality. We aim to evaluate the incidence, diagnostic criteria, morbidity, and mortality related with AL.

Methods: This is a cohort, descriptive retrospective, single-centred study of consecutive patients who underwent surgery with a colorectal anastomosis for colorectal cancer, over a 4-year period (2013-2016).

Results: From 2013 to 2016, a total of 480 patients were included. A total of 37 (7.7%) had an anastomotic leakage. AL was diagnosed after 6.8 days in average, most frequently on day 5. 25 out of the 37 patients were diagnosed based on clinical criteria, and the remaining had a CT scan imaging. Clavien-Dindo grade III and IV complications was significantly higher in the AL group (70.2 vs. 7.7%, p<0.0005). Mortality was higher in the leakage group (21.6% vs. 4.7%, p< 0.0005).

Conclusions: In this study, most patients were diagnosed early based on clinical criteria, and imaging studies were associated with a significant delay in diagnosis. Leakage group had higher morbidity, mortality and rate of reoperations. Early reoperation may have a positive impact in Failure-to-Rescue rate reduction, but additional prospective studies are needed.

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