Anastomotic leakage following resention for cancer of the colon and rectum.

A total of 270 concecutive patients were examined for anastomotic leakage following resection for cancer of the colon and rectum. A 2-layer anastomosis was established 215 cases and a 3-layer one in 43. Twelve patients underwent the resection during manifest ileus. The total frequency of anastomotic leakage after elective resections was 14% significantly higher in the left than in the right half of the colon, irrespective of the anastomotic technique used. Age and sex per se did not influence the frequency of leakage. On the other hand, the presence of various complications at admission (cardiopulmonary, weight loss, metabolic disorders and anaemia, hypoproteinaemia, or electrolyte disturbances) was attended by an increased frequency of anastomotic leaks after left-sided resections. Pallative resection as well as resection of left-side tumour during manifest ileus was accompanied by an increased frequency of anastomotic leakage. There was also an increased tendency for leakage to occur when left-sided tumours were treated by a temporary defunctioning caecostomy rather than by transverse colostomy.