Prevention of anastomotic leak following surgical treatment for rectal cancer

INTRODUCTION: Anastomotic leak (AL) is a major complication to surgical treatment of colorectal cancer affecting approximately 12% of patients. AL is associated with a 6-30% mortality. Finding methods that may reduce the incidence of AL is therefore important. In this study, we aimed to examine the effect of mechanical bowel preparation (MBP) and oral antibiotics on the rate of AL.

METHODS: This was a retrospective, single-centre analysis of patients undergoing surgical treatment for rectal cancer. We included 150 consecutive patients treated from July 2014 to October 2018. From June 2017 onwards, 50 patients comprised the study group (receiving MBP and oral antibiotics), while the preceding 100 patients served as a control group (receiving a rectal enema).

RESULTS: Two cases (4%) of AL were found in the study group and 20 cases (20%) in the control group (p lesser-than 0.01). Converting from laparoscopy to open surgery or having a World Health Organization performance score 2-3 were also associated with AL in univariate analysis.

CONCLUSION: Administrating MBP and oral antibiotics prior to surgery seems to reduce the incidence of AL following rectal cancer surgery.

FUNDING: none.

TRIAL REGISTRATION: not relevant.