Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life
Purpose Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes. Methods A retrospective audit of all rectal resec...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Coloproctology
2023-10-01
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| Series: | Annals of Coloproctology |
| Subjects: | |
| Online Access: | http://coloproctol.org/upload/pdf/ac-2022-00073-0010.pdf |
| _version_ | 1797646302910087168 |
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| author | Angelina Di Re Salam Tooza Jason Diab Charbel Karam Mina Sarofim Kevin Ooi Catherine Turner Daniel Kozman David Blomberg Matthew Morgan |
| author_facet | Angelina Di Re Salam Tooza Jason Diab Charbel Karam Mina Sarofim Kevin Ooi Catherine Turner Daniel Kozman David Blomberg Matthew Morgan |
| author_sort | Angelina Di Re |
| collection | DOAJ |
| description | Purpose Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes. Methods A retrospective audit of all rectal resections performed at a colorectal unit and associated private hospitals over the past 10 years was performed. Relevant demographic, operative, and histopathological data were collected. A prospective survey was performed regarding patients’ quality of life and fecal continence. These patients were matched with nonAL patients who completed the same survey. Results One hundred patients (out of 1,394 resections) were included. AL was contained in 66.0%, not contained in 10.0%, and only anastomotic stricture in 24.0%. Management was antibiotics only in 39.0%, percutaneous drainage in 9.0%, operative abdominal drainage in 19.0%, transrectal drainage in 6.0%, combination of percutaneous drainage and transrectal drainage in 2.0%, and combination abdominal/transrectal drainage in 1.0%. The 1-year stoma rate was 15.0%. Overall, mean Fecal Incontinence Severity Instrument scores were higher for AL patients than their matched counterparts (8.06±10.5 vs. 2.92±4.92, P=0.002). Patients with an AL had a mean EuroQol visual analogue scale (EQ-VAS) of 76.23±19.85; this was lower than the matched mean EQ-VAS for non-AL patients of 81.64±18.07, although not statistically significant (P=0.180). Conclusion The majority of AL patients in this study were managed with antibiotics only. AL was associated with higher fecal incontinence scores in the long-term; however, this did not equate to lower quality of life scores. |
| first_indexed | 2024-03-11T14:59:39Z |
| format | Article |
| id | doaj.art-4f69a7c3ccde45e39b4c7c2da1e895e1 |
| institution | Directory Open Access Journal |
| issn | 2287-9714 2287-9722 |
| language | English |
| last_indexed | 2024-03-11T14:59:39Z |
| publishDate | 2023-10-01 |
| publisher | Korean Society of Coloproctology |
| record_format | Article |
| series | Annals of Coloproctology |
| spelling | doaj.art-4f69a7c3ccde45e39b4c7c2da1e895e12023-10-30T07:59:51ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222023-10-0139539540110.3393/ac.2022.00073.00101929Outcomes following anastomotic leak from rectal resections, including bowel function and quality of lifeAngelina Di Re0Salam Tooza1Jason Diab2Charbel Karam3Mina Sarofim4Kevin Ooi5Catherine Turner6Daniel Kozman7David Blomberg8Matthew Morgan9 Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia Department of Colorectal Surgery, Bankstown-Lidcombe Hospital, Bankstown, NSW, AustraliaPurpose Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes. Methods A retrospective audit of all rectal resections performed at a colorectal unit and associated private hospitals over the past 10 years was performed. Relevant demographic, operative, and histopathological data were collected. A prospective survey was performed regarding patients’ quality of life and fecal continence. These patients were matched with nonAL patients who completed the same survey. Results One hundred patients (out of 1,394 resections) were included. AL was contained in 66.0%, not contained in 10.0%, and only anastomotic stricture in 24.0%. Management was antibiotics only in 39.0%, percutaneous drainage in 9.0%, operative abdominal drainage in 19.0%, transrectal drainage in 6.0%, combination of percutaneous drainage and transrectal drainage in 2.0%, and combination abdominal/transrectal drainage in 1.0%. The 1-year stoma rate was 15.0%. Overall, mean Fecal Incontinence Severity Instrument scores were higher for AL patients than their matched counterparts (8.06±10.5 vs. 2.92±4.92, P=0.002). Patients with an AL had a mean EuroQol visual analogue scale (EQ-VAS) of 76.23±19.85; this was lower than the matched mean EQ-VAS for non-AL patients of 81.64±18.07, although not statistically significant (P=0.180). Conclusion The majority of AL patients in this study were managed with antibiotics only. AL was associated with higher fecal incontinence scores in the long-term; however, this did not equate to lower quality of life scores.http://coloproctol.org/upload/pdf/ac-2022-00073-0010.pdfanastomotic leakfecal incontinencequality of liferectal neoplasms |
| spellingShingle | Angelina Di Re Salam Tooza Jason Diab Charbel Karam Mina Sarofim Kevin Ooi Catherine Turner Daniel Kozman David Blomberg Matthew Morgan Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life Annals of Coloproctology anastomotic leak fecal incontinence quality of life rectal neoplasms |
| title | Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life |
| title_full | Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life |
| title_fullStr | Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life |
| title_full_unstemmed | Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life |
| title_short | Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life |
| title_sort | outcomes following anastomotic leak from rectal resections including bowel function and quality of life |
| topic | anastomotic leak fecal incontinence quality of life rectal neoplasms |
| url | http://coloproctol.org/upload/pdf/ac-2022-00073-0010.pdf |
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