wetenschapsdag 2023 | 35 Sessie 1b: Ticks, Checks and Balances x3 Auteurs E.W. Ingwersen, D.E. Huisman, E.E. van der Meulen, B.T. Bootsma, G. Kazemier, H.M. Kroon, I. Murshed, T. Sammour, F. Daams Abstract titel Impact of anastomotic bowel leakage on oncological outcomes and stoma presence Background Literature on the long-term effects of anastomotic bowel leakage (ABL) with regards to postoperative oncological outcomes and stoma presence is equivocal. Understanding the association between ABL and long-term outcomes is crucial for patient follow-up, counseling, and tailored treatment decisions. Objective was to investigate the impact of ABL on cancer recurrence and stoma presence in patients undergoing colon and rectal cancer surgery. Methods This prospective cohort study was conducted in patients included in the LekCheck study. Follow-up period was 5 years. This multicenter international study conducted in 14 hospitals in three countries including patients undergoing colon cancer surgery and rectal cancer surgery and were analyzed separately. Patients with a primary anastomosis were included. The outcomes assessed were cancer recurrence rate, overall survival, disease-free survival, and stoma presence at five years of follow-up, stratified based on ABL. Results A total of 1 042 patients were included. ABL was not significantly associated with cancer recurrence, overall survival, or disease-free survival after colon or rectal cancer surgery. However, for colon cancer surgery, ABL was associated with the presence of a stoma at five years of follow-up (18.8% vs 1.9%, odds ratio 16.96, 95% confidence interval 8.69 – 33.10, P<0.001). Similarly, in rectal cancer surgery, stoma presence at five years was significantly higher in patients after ABL (21.9% vs 1.9%, odds ratio 5.61, 95% confidence interval 1.82 - 17.27, P<0.001). Conclusion This study did not demonstrate a negative impact of ABL on oncological outcomes. However, ABL was strongly associated with an increased incidence of stoma presence after five years, significantly affecting the patients’ quality of life after colon and rectal cancer surgery.
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