FP1.7 - Colorectal Anastomotic leaks after malignant resections: A cohort study

Aims Colorectal anastomotic leaks (AL) is serious complication in restorative colorectal cancer surgery, reported incidence of <10%. AL can adversely affect long term survival. Aim of study is to assess management of colorectal anastomotic leaks at a single centre. Methods Cohort study was carried out from Jan2008 to Jan2024. Descriptive demography and post-operative outcomes were evaluated for AL, non-leaks recruited as controls Results A L (n = 66) Non Leaks (n = 1644) Mann Whitney U test (p value) Age(yrs) 67.8 70.5 <0.05 Sex(M:F) 41 : 25 915 : 729 NS ASA(median) 2 2 NS BMI(kg/m2) 27.3 26.5 NS Emerg : Elec(n) 7 : 59 355 : 1289 <0.05 Lap : Open(n) 31 : 35 927 : 717 <0.0001 LN harvest(n) 16 17 NS Leaks Rx Type A (antibiotics) 29 Type B (drainage) 10 Type C (surgery) 27 Days to Leak(Med) 6 Leak day Day 6 WCC(10x9/L) 14.1 9.4 <0.001 CRP(mg/L) 226.5 118.1 <0.0001 Op time(mins) 178.3 174.9 NS LOS(days) 14.5 < 0.0001 Complication(n) Ileus 14 260 NS HAP 7 178 NS Anaemia(transfusion) 1 52 NS Wound infections 5 150 NS Collections 31 65 <0.0001 Sepsis 13 73 <0.05 Mortality(n) 30 day 1 57 NS 60 day 2 82 NS 90 day 3 95 NS Survival rates(%) 1st year 88.7 86.0 5th year 79.7 68.8 Logrank 10th year 72.0 60.7 p=NS 15th year 67.7 57.8 Conclusion AL occurred in 3.8 % all colorectal cancer resections, 40.9 % requiring surgery (type C-1.6 %). AL associated with rise in WCC & CRP, but early radiological diagnosis is essential. Despite prolonged hospitalization, there was no reduced survival.