IMPACT OF DIFFERENT COLORECTAL ANASTOMOTIC TECHNIQUES ON POSTOPERATIVE OUTCOMES

Abstract

This article presents the results of a study aimed at evaluating the association between different colorectal anastomosis techniques (end-to-end and side-to-end) and the development of postoperative complications, as well as their risk factors (BMI, stoma, neoadjuvant chemotherapy, comorbidities) in patients with rectal cancer. The study included 192 patients who underwent surgical treatment for rectal cancer at the Republican Diagnostic Center between 2017 and 2022. End-to-end colorectal anastomosis was performed in 68 patients, while side-to-end anastomosis was applied in 124 patients. Ileostomy was created in 30 patients. Anastomotic leakage occurred in 9 patients (13.2%) in the end-to-end anastomosis group and in 3 patients (2.4%) in the side-to-end anastomosis group (p<0.001). The study demonstrated that a high body mass index (≥30 kg/m²), neoadjuvant radiotherapy and chemotherapy, as well as the presence of comorbidities significantly increase the risk of anastomotic leakage. According to the authors, the use of side-to-end anastomosis in rectal cancer surgery significantly reduces the incidence of anastomotic leakage, the need for ileostomy, and reoperation rates, and can therefore be considered a more ureliable and safer surgical approach. Neoadjuvant radiotherapy and chemotherapy, age over 50 years, comorbidities, and high body mass index should be regarded as major risk factors for anastomotic leakage.