n South African Journal of Surgery - Impaired anastomotic healing after preoperative radiotherapy followed by anterior resection for treatment of rectal carcinoma : general surgery




<I>Background.</I> Patients with rectal carcinoma undergoing total mesorectal excision (TME) have a lower recurrence rate with preoperative radiotherapy (RT). the aim of this study was to assess the side-effects in patients who had preoperative RT compared with those who did not receive it (because of palliative resections, advanced age or refusal). <BR><I>Methods.</I> From January 2001 to march 2003, 40 patients underwent resection and double-stapled anastomosis for rectal carcinoma. we compared 17 patients who received RT followed by resection and low rectal anastomosis, with 23 patients who did not have RT. <BR><I>Results.</I> After surgery 7/17 of the patients who had received Rt developed anastomotic leaks. Anastomotic leakage was seen only once in the patients who did not have RT (41% v. 4%, <I>p</I> = 0.006). A protective stoma, which was performed in 11 patients in the RT group, did not prevent anastomotic leakage (4/11 leakage with stoma v. 3/6 leakage without stoma, <I>p</I> = 0.64). median hospital stay was longer in the RT group (17.4 v. 13.7 days, <I>p</I> = 0.017). there was no difference in the number of minor postoperative complications between the two groups (24% v. 22%). <BR><I>Conclusion.</I> Compared with surgery alone, preoperative short-term RT increased the number of anastomotic leaks and hospital stay, whether or not a protective stoma was performed.


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