Abstract
To clarify factors improving the condition of anastomotic leakage that is one of the severe postoperative complications of colorectal cancer, we retrospectively examined consecutive 675 patients undergoing ordinary or emergency operation for colorectal cancer at this hospital for the past 12 years. In this study, we also examined the correlation between ileus and anastomotic leakage, particularly whether preoperative insertion of a retrograde decompression ileus tube was useful for the prevention of anastomotic leakage. Anastomotic leakage occurred in 47 patients (7.0%). Male, preoperative ileus, cancer of the lower part of rectum and lymph node metastasis were risk factors of anastomotic leakage. Of 34 patients treated conservatively, there was a significantly negative correlation (p<0.001) between the day of the onset of anastomotic leakage and the day of beginning of oral intake. Of the 47 patients experienced anastomotic leakage, eight patients underwent reoperation, but after the reoperation, all patients had a good postoperative course. Five out of the 47 patients with anastomotic leakage (10.6%) died in the hospital. The mortality rate in the patients with anastomotic leakage was significantly higher than those without episodes of anastomotic leakage (hospital death 1.9%). We were able to decrease the incidence of anastomotic leakage as well as emergency operations for patients with colorectal cancer presented with ileus, by inserting a retrograde decompression ileus tube.
