AB201. SOH25_AB_306. Management of anastomotic leak after rectal cancer resection: a systematic review and pooled analysis
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AB201. SOH25_AB_306. Management of anastomotic leak after rectal cancer resection: a systematic review and pooled analysis

Ruth Walsh1, Edward Murphy1, Eanna Ryan2, Ronan Cahill1,2

1Centre for Precision Surgery, School of Medicine, University College Dublin, Dublin, Ireland; 2Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland

Background: Anastomotic leak represents a considerable challenge after colorectal surgery. We aimed to conduct a systematic review of the management of anastomotic leak after rectal cancer resection.

Method: A systematic review was performed as per AMSTAR2 guidelines. We used the EMBASE, PubMed, and Scopus databases to identify studies fitting our inclusion/exclusion criteria.

Results: In total, 16 retrospective studies including 854 patients were included. All were retrospective studies with an overall moderate risk of bias. Of these patients, 73% were male and 27% were female, with a mean weighted age of 62 (±8.6) years. Nine (1.03%) patients were managed with watchful waiting, 591 (68.24%) with drainage, 151 (18.47%) with anastomosis-conserving surgery, and 103 (12.24%) with surgery with anastomotic takedown (including re-do anastomosis). The success rates of these interventions were 66.7%, 73.7%, 69.7%, and 77.0%, respectively. Of note, there was a negligible difference between the success rates of active and passive drainage.

Conclusions: This review demonstrates that drainage procedures have high success rates and are suitable choices given their lower morbidity, mortality, and permanent stoma rates compared to surgical options. This review did not find a difference in success rates between active and passive drainage.

Keywords: Rectal cancer; anastomotic leak; treatment; meta-analysis; surgical oncology

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab201
Cite this abstract as: Walsh R, Murphy E, Ryan E, Cahill R. AB201. SOH25_AB_306. Management of anastomotic leak after rectal cancer resection: a systematic review and pooled analysis. Mesentery Peritoneum 2025;9:AB201.

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