P-297 Anastomotic leakage in patients operated for colorectal cancer in a high volume UK centre within an enhanced recovery programme setting
Authors: J. Ng, K. Goonetilleke, V. Decaro, A. Sequiera, S. Bassiony, G. Elshetwy, S. Sandey
Journal: Annals of Oncology (2015)

Introduction: Anastomotic leak is one of the serious complications in colorectal cancer surgery. It is associated with reduced 5-year cancer-specific survival, higher recurrence, a source of morbidity and mortality (20 to 23%) with an extra cost to healthcare: £1 million - £3.5 million annually. The purpose of this study was to determine the anastomotic leakage in a high volume centre in the United Kingdom with an established laparoscopic and enhanced recovery programme.Methods: A retrospective analysis of patients undergoing colorectal cancer resections in our hospital was performed from 2013 to 2014 from a prospectively maintained enhanced recovery database. Anastomotic leak was defined as requiring further clinical intervention (antibiotics +/- radiological drainage +/- surgery) AND confirmed radiologically.Results: A total of 187 patients underwent cancer resection with an anastomosis.103 patients had anterior resections and 84 had hemicolectomies.157 patients (84%) were laparoscopic resections.5 (6%) anterior resections leaked and 4(3.8%) hemicolectomies leaked with an overall leakage of 4.8%. 4 patients who leaked were taken back to theatre (2%) with 1 treated with radiological drainage and 4 treated with antibiotics.Conclusion: Leak rates for both anterior resection and other colonic resections are below recommended targets by ACPGBI. Based on this data a safe service can be provided in a high volume centre with a high provision of laparoscopic resections within an enhanced recovery programme. Introduction: Anastomotic leak is one of the serious complications in colorectal cancer surgery. It is associated with reduced 5-year cancer-specific survival, higher recurrence, a source of morbidity and mortality (20 to 23%) with an extra cost to healthcare: £1 million - £3.5 million annually. The purpose of this study was to determine the anastomotic leakage in a high volume centre in the United Kingdom with an established laparoscopic and enhanced recovery programme. Methods: A retrospective analysis of patients undergoing colorectal cancer resections in our hospital was performed from 2013 to 2014 from a prospectively maintained enhanced recovery database. Anastomotic leak was defined as requiring further clinical intervention (antibiotics +/- radiological drainage +/- surgery) AND confirmed radiologically. Results: A total of 187 patients underwent cancer resection with an anastomosis.103 patients had anterior resections and 84 had hemicolectomies.157 patients (84%) were laparoscopic resections.5 (6%) anterior resections leaked and 4(3.8%) hemicolectomies leaked with an overall leakage of 4.8%. 4 patients who leaked were taken back to theatre (2%) with 1 treated with radiological drainage and 4 treated with antibiotics. Conclusion: Leak rates for both anterior resection and other colonic resections are below recommended targets by ACPGBI. Based on this data a safe service can be provided in a high volume centre with a high provision of laparoscopic resections within an enhanced recovery programme.