What is the clinical evidence from this study?

Study design: Cohort. Population: colorectal cancer (n=943). Intervention: Rectal cancer surgery vs. Colon cancer surgery. Primary outcome: 30-day anastomotic leak incidence (adjusted OR 3.61, 95% CI 1.74-7.48, p=<0.001).

What does this research mean for the field?

Although anastomotic leak occurs in fewer than 6% of elective colorectal cancer resections, it causes severe postoperative deterioration characterized by high rates of major morbidity, surgical reintervention, and mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the incidence, severity, management, and early postoperative consequences of anastomotic leak following elective colorectal cancer resection.

September 8, 2026Journal of Clinical MedicineOpen Access

Clinical Burden of Anastomotic Leak After Elective Colorectal Cancer Surgery: A Multicenter Cohort Study

Q: What are the key findings of this study?

Rectal cancer surgery was independently associated with a higher risk of 30-day anastomotic leak compared to colon cancer surgery (8.8% vs. 4.5%; adjusted OR 3.61; 95% CI 1.74-7.48; p<0.001).

Q: What does this research mean for the field?

Although anastomotic leak occurs in fewer than 6% of elective colorectal cancer resections, it causes severe postoperative deterioration characterized by high rates of major morbidity, surgical reintervention, and mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the incidence, severity, management, and early postoperative consequences of anastomotic leak following elective colorectal cancer resection.

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Key result

Rectal cancer surgery is linked to ~261% higher 30-day anastomotic leak risk versus colon surgery.

adjusted OR 3.61
95% CI 1.74-7.48
P<0.001
n=943

Why the study?

While most studies focus on prediction or prevention, less is known about the clinical course, severity, management, and early postoperative consequences after anastomotic leak diagnosis.

Population

943 patients with an evaluable anastomosis undergoing elective colorectal cancer resection across five tertiary referral centers

Design

Retrospective multicenter cohort study

Follow-up

30 days

Authors

TCTomasz CwalinskiNicolaus Copernicus University PKPatryk KaczorNicolaus Copernicus University BKBartosz KapturkiewiczLublin Oncology Center

Discussion

Member takes

Implication

Rectal resections may warrant closer leak surveillance; extends site-specific risk data but leaves optimal prevention strategies open.

Key Points

To evaluate the incidence, severity, management, and early postoperative consequences of anastomotic leak following elective colorectal cancer resection.
Conducted a retrospective multicenter cohort study of N=943 consecutive patients undergoing elective colorectal cancer resection with restored continuity across five tertiary referral centers.
Evaluated 30-day leak incidence as the primary outcome and analyzed risk factors using Firth penalized logistic regression.
Anastomotic leak occurred in 5.8% (55/943) of patients and was more frequent after rectal than colon cancer surgery (8.8% vs. 4.5%; crude OR 2.04, 95% CI 1.18–3.53, p=0.016; adjusted OR 3.61, 95% CI 1.74–7.48, p<0.001).
Intraoperative indocyanine green fluorescence angiography showed no independent association with leak occurrence (adjusted OR 1.02, 95% CI 0.48–2.17, p=0.962).
Following leak diagnosis, 92.7% of patients experienced major morbidity, 76.4% required surgical reintervention, 65.4% remained hospitalized beyond 14 days, and 30-day mortality reached 10.9%.

Study Design

Type

Cohort (n=943)

Multicenter

Yes

Structured PICO

Population

943 consecutive patients undergoing elective colorectal cancer resection with restoration of bowel continuity in five tertiary referral centers.

Outcome

30-day anastomotic leak incidencesafety

Main Result

Odds Ratio: 3.61 (95% CI 1.74–7.48)

Absolute Event Rate: 8.8% vs 4.5%

p-value: p=<0.001

Anastomotic leak after elective colorectal cancer surgery occurs in about 5.8% of cases, particularly after rectal surgery, and leads to severe postoperative morbidity and high reintervention rates.

Cite This Study

Cwalinski et al. (2026) conducted a cohort in colorectal cancer (n=943). Rectal cancer surgery vs. Colon cancer surgery was evaluated on 30-day anastomotic leak incidence (adjusted OR 3.61, 95% CI 1.74-7.48, p=<0.001). Rectal cancer surgery was independently associated with a higher risk of 30-day anastomotic leak compared to colon cancer surgery (8.8% vs. 4.5%; adjusted OR 3.61; 95% CI 1.74-7.48; p<0.001).

synapsesocial.com/papers/6a9fd7d558e84d0ff5b46dcb https://doi.org/10.3390/jcm15176903

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September 8, 2026Journal of Clinical MedicineOpen Access

Clinical Burden of Anastomotic Leak After Elective Colorectal Cancer Surgery: A Multicenter Cohort Study

View Full Paper

Ask AI

Bookmark

Key result

Rectal cancer surgery is linked to ~261% higher 30-day anastomotic leak risk versus colon surgery.

adjusted OR 3.61
95% CI 1.74-7.48
P<0.001
n=943

Why the study?

While most studies focus on prediction or prevention, less is known about the clinical course, severity, management, and early postoperative consequences after anastomotic leak diagnosis.

Population

943 patients with an evaluable anastomosis undergoing elective colorectal cancer resection across five tertiary referral centers

Design

Retrospective multicenter cohort study

Follow-up

30 days

Authors

TCTomasz CwalinskiNicolaus Copernicus University PKPatryk KaczorNicolaus Copernicus University BKBartosz KapturkiewiczLublin Oncology Center

Discussion

Member takes

Implication

Rectal resections may warrant closer leak surveillance; extends site-specific risk data but leaves optimal prevention strategies open.

Key Points

To evaluate the incidence, severity, management, and early postoperative consequences of anastomotic leak following elective colorectal cancer resection.
Conducted a retrospective multicenter cohort study of N=943 consecutive patients undergoing elective colorectal cancer resection with restored continuity across five tertiary referral centers.
Evaluated 30-day leak incidence as the primary outcome and analyzed risk factors using Firth penalized logistic regression.
Anastomotic leak occurred in 5.8% (55/943) of patients and was more frequent after rectal than colon cancer surgery (8.8% vs. 4.5%; crude OR 2.04, 95% CI 1.18–3.53, p=0.016; adjusted OR 3.61, 95% CI 1.74–7.48, p<0.001).
Intraoperative indocyanine green fluorescence angiography showed no independent association with leak occurrence (adjusted OR 1.02, 95% CI 0.48–2.17, p=0.962).
Following leak diagnosis, 92.7% of patients experienced major morbidity, 76.4% required surgical reintervention, 65.4% remained hospitalized beyond 14 days, and 30-day mortality reached 10.9%.

Study Design

Type

Cohort (n=943)

Multicenter

Yes

Structured PICO

Population

943 consecutive patients undergoing elective colorectal cancer resection with restoration of bowel continuity in five tertiary referral centers.

Outcome

30-day anastomotic leak incidencesafety

Main Result

Odds Ratio: 3.61 (95% CI 1.74–7.48)

Absolute Event Rate: 8.8% vs 4.5%

p-value: p=<0.001

Anastomotic leak after elective colorectal cancer surgery occurs in about 5.8% of cases, particularly after rectal surgery, and leads to severe postoperative morbidity and high reintervention rates.

Cite This Study

synapsesocial.com/papers/6a9fd7d558e84d0ff5b46dcb https://doi.org/10.3390/jcm15176903

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