Neoadjuvant Therapy and Anastomotic Leak After Tumor-Specific Mesorectal Excision for Rectal Cancer Export

@article{citeulike:3152227, abstract = {Abstract Purpose\ \ This study was designed to evaluate whether neoadjuvant therapy is a risk factor for anastomotic leakage after rectal cancer surgery. Methods\ \ A retrospective review of 220 patients who underwent tumor-specific mesorectal excision for rectal cancer from 2000 to 2005 was performed. Risk factors for leak were identified by using a multivariable regression model. Results\ \ A total of 54 patients received neoadjuvant chemoradiation therapy and surgery, whereas 166 received surgery alone. No difference in clinically significant leaks was observed between the two groups (5.6 vs. 6.6 percent, P = 1). A diverting ileostomy was performed in 26.4 percent of patients who received neoadjuvant therapy compared with 9.7 percent for surgery alone (P = 0.0021). Neoadjuvant patients were more likely to have ultralow anastomoses (17.6 vs. 2.5 percent, P \< 0.0001). On multivariate analysis, smoking (odds ratio, 6.37 (1.8, 22.2), P = 0.004), difficult anastomosis (odds ratio, 7.66 (1.8, 31.5), P = 0.0048), and low level of anastomosis (≤4\ cm from the verge; odds ratio, 5.28 (1.05, 26.6), P = 0.044) were independently associated with anastomotic leakage. Conclusions\ \ Significant predictors of anastomotic leak include smoking, difficult anastomosis, and level of anastomosis (≤4\ cm). Neoadjuvant chemoradiation therapy was not found to be significantly associated with leakage after tumor-specific mesorectal excision for rectal cancer.}, author = {Martel, Guillaume and Al-Suhaibani, Youssuf and Moloo, Husein and Haggar, Fatima and Friedlich, Martin and Mamazza, Joseph and Poulin, Eric and Stern, Hartley and Boushey, Robin}, citeulike-article-id = {3152227}, citeulike-linkout-0 = {http://dx.doi.org/10.1007/s10350-008-9368-3}, day = {1}, doi = {10.1007/s10350-008-9368-3}, journal = {Diseases of the Colon \& Rectum}, number = {8}, pages = {1195--1201}, posted-at = {2008-08-24 20:18:19}, priority = {2}, title = {Neoadjuvant Therapy and Anastomotic Leak After Tumor-Specific Mesorectal Excision for Rectal Cancer}, url = {http://dx.doi.org/10.1007/s10350-008-9368-3}, volume = {51}, year = {2008} }

TY - JOUR ID - citeulike:3152227 L3 - citeulike-article-id:3152227 N2 - Abstract Purpose  This study was designed to evaluate whether neoadjuvant therapy is a risk factor for anastomotic leakage after rectal cancer surgery. Methods  A retrospective review of 220 patients who underwent tumor-specific mesorectal excision for rectal cancer from 2000 to 2005 was performed. Risk factors for leak were identified by using a multivariable regression model. Results  A total of 54 patients received neoadjuvant chemoradiation therapy and surgery, whereas 166 received surgery alone. No difference in clinically significant leaks was observed between the two groups (5.6 vs. 6.6 percent, P = 1). A diverting ileostomy was performed in 26.4 percent of patients who received neoadjuvant therapy compared with 9.7 percent for surgery alone (P = 0.0021). Neoadjuvant patients were more likely to have ultralow anastomoses (17.6 vs. 2.5 percent, P < 0.0001). On multivariate analysis, smoking (odds ratio, 6.37 (1.8, 22.2), P = 0.004), difficult anastomosis (odds ratio, 7.66 (1.8, 31.5), P = 0.0048), and low level of anastomosis (≤4 cm from the verge; odds ratio, 5.28 (1.05, 26.6), P = 0.044) were independently associated with anastomotic leakage. Conclusions  Significant predictors of anastomotic leak include smoking, difficult anastomosis, and level of anastomosis (≤4 cm). Neoadjuvant chemoradiation therapy was not found to be significantly associated with leakage after tumor-specific mesorectal excision for rectal cancer. IS - 8 JF - Diseases of the Colon & Rectum EP - 1201 TI - Neoadjuvant Therapy and Anastomotic Leak After Tumor-Specific Mesorectal Excision for Rectal Cancer VL - 51 SP - 1195 AU - Martel, Guillaume AU - Al-Suhaibani, Youssuf AU - Moloo, Husein AU - Haggar, Fatima AU - Friedlich, Martin AU - Mamazza, Joseph AU - Poulin, Eric AU - Stern, Hartley AU - Boushey, Robin PY - 2008//01/ UR - http://dx.doi.org/10.1007/s10350-008-9368-3 ER -