P-297 - Anastomotic leakage in patients operated for colorectal cancer in a high volume UK centre within an enhanced recovery programme setting

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Complications of Treatment
Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter J. Ng
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J. Ng1, K. Goonetilleke2, V. Decaro1, A. Sequiera1, S. Bassiony1, G. Elshetwy1, S. Sandey1
  • 1Worcester Royal Hospital, Worcester/UK
  • 2Worcestershire Acute Hospitals NHS Trust, Worcester/UK

Abstract

Introduction

Anastomotic leak is one of the serious complications in colorectal cancer surgery. It is associated with reduced 5-year cancer-specific survival, higher recurrence, a source of morbidity and mortality (20 to 23%) with an extra cost to healthcare: £1 million - £3.5 million annually. The purpose of this study was to determine the anastomotic leakage in a high volume centre in the United Kingdom with an established laparoscopic and enhanced recovery programme.

Methods

A retrospective analysis of patients undergoing colorectal cancer resections in our hospital was performed from 2013 to 2014 from a prospectively maintained enhanced recovery database. Anastomotic leak was defined as requiring further clinical intervention (antibiotics +/- radiological drainage +/- surgery) AND confirmed radiologically.

Results

A total of 187 patients underwent cancer resection with an anastomosis.103 patients had anterior resections and 84 had hemicolectomies.157 patients (84%) were laparoscopic resections.5 (6%) anterior resections leaked and 4(3.8%) hemicolectomies leaked with an overall leakage of 4.8%. 4 patients who leaked were taken back to theatre (2%) with 1 treated with radiological drainage and 4 treated with antibiotics.

Conclusion

Leak rates for both anterior resection and other colonic resections are below recommended targets by ACPGBI. Based on this data a safe service can be provided in a high volume centre with a high provision of laparoscopic resections within an enhanced recovery programme.