SP6.14 The risk of anastomotic leak in right sided hemicolectomy for malignant and benign pathology, predisposing factors and its impact on long-term survival and oncological outcome

Introduction Anastomotic leak can have significant impact on peri-operative outcome. The aim of this study was to report the rate of anastomotic leak in patients undergoing right hemicolectomy, to identify factors associated with anastomotic leak and its impact on long-term outcome. Method An prospective observational cohort study of patients undergoing both emergency and elective right-sided hemicolectomy between 2010-2020 was conducted. Each patient had subsequently followed up for complications and survival and the impact of resection status on outcome were determined. Univariate and multivariate analysis (logistic and CPHM) were conducted. Results A total of 1206 patients were included (M:F 0.8:1, median age, 71; 929 malignant cases; 277 benign cases) and the anastomotic leak rate was 4.4% (53/1206). Obesity (BMI>30kg/m2) (6.5% vs. 3.8%; OR 2.39, p=0.043) and increasing ASA (OR 2.41, p=0.034) were the only factors associated with anastomotic leak. Anastomotic leak was associated with inpatient mortality (15.1%; OR=20.5, p<0.001) and earlier long-term mortality (median survival 58.9 vs. 128.5 months). Patients with colon cancer who suffered anastomotic leak also had inferior disease free survival (median time, 92 vs. 113 months, p=0.013) Discussion Patients with a higher BMI are more likely to suffer an anastomotic leak in right-sided hemicolectomy. Although rates of anastomotic leak are low in contemporary practice, they have a significant impact on both long term overall and disease-free survival.