Delayed Anastomotic Failure After Chemoradiation: A Delay in Diagnosis or Late Presentation? - A Case Series
Corresponding AuthorNell Maloney Patel
Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
A B S T R A C T
Anastomotic leak after colorectal surgery can result in serious morbidity for certain patients. The rate of clinically significant anastomotic leak after colon resection ranges from 1.8% to 11.9%. Risk factors include male sex, steroids, smoking, perioperative blood transfusion, malnutrition, and a low anastomosis. However, the effect of pre-operative chemoradiation therapy (CRT) on rates of anastomotic leak is controversial. Specifically, late leaks, which are defined as those that occur greater than 30 days after surgery, are sparsely described in current literature. Recent evidence suggests that CRT may contribute to the presentation of late anastomotic leaks. In this case series, we report our experience with three patients who received CRT and developed varying presentations of a late anastomotic leak. Therefore, our experience supports the consideration of late anastomotic leaks as a separate entity in colorectal surgery. While pre-operative CRT may increase risk for postoperative anastomotic leak overall, further exploration into the relationship between preoperative CRT and late anastomotic leaks is warranted.
Article TypeCase Series
Publication historyReceived: Tue 15, Jun 2021
Accepted: Fri 17, Sep 2021
Published: Thu 30, Sep 2021
Copyright© 2021 Nell Maloney Patel. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.