Abstract
Anastomotic dehiscence following rectal anastomosis continues to pose a serious clinical problem. Between April 1995 and December 2007, 290 patients underwent sphincter-saving operations for rectal cancer in our center. Of those, 39 patients (13%) developed anastomotic leakage. It was noted that leakage occurred in 29% of the patients who had surgery for low rectal (Rb) cancer. Male gender, lower rectal tumor, bowel obstruction prior to surgery, diabetes, longer operating time and greater blood loss were significant risk factors for anastomotic leakage. Two patients developed generalized peritonitis which required emergency re-laparotomy with fashioning of ileostomy while the remaining 37 patients were treated conservatively. Closure of the fistulas was achieved in 30 out of 37 patients who initially had conservative treatment, leaving 7 who eventually required ileostomy or colostomy. Healing of the fistulas tended to take longer in patients of male gender or lower tumor and in patients who developed leakage in earlier postoperative days.
