Late anastomotic leakage in colorectal surgery: a significant problem

Aim Reported incidence rates of colorectal anastomotic leakage (AL) vary between 2.5 and 20%. There is little information on late anastomotic leakage (LAL). The aim of this study was to determine the incidence of LAL after colorectal resection. Method All patients undergoing colorectal resection with primary anastomosis between January 2004 and October 2009 at the University Medical Center Groningen were included. LAL was defined as anastomotic leakage diagnosed more than 30days after surgery. Results One hundred and forty-one patients were analysed. Indications for surgery included both benign and malignant conditions. The incidence of early anastomotic leakage (EAL) within 30days after surgery was 13%. The LAL rate was 6%. Eighty-nine per cent of patients with EAL underwent relaparotomy compared with 44% for LAL (P=0.02). Conclusion One-third of all anastomotic leakages were diagnosed more than 30days after surgery. Of these, 44% underwent relaparotomy. Patients with leakage diagnosed within 30days after surgery were more likely to undergo relaparotomy. LAL is a significant problem after colorectal surgery.