Dissecting the outcomes of anterior resections in a high-volume center

Published Date: 15th September 2021

Publication Authors: Rowe AK, Adderley A, Samad A, Javed M

Purpose
To analyse outcomes of patients undergoing anterior resections in a high-volume colorectal unit as proposed by the ACPGBI guidelines.

Methods
Retrospective analysis of 218 patients, undergoing anterior resections between January 2017 and December 2019.

Results
Median age was 67 years (IQR: 58–76), including 9 emergency resections. Indications were benign disease in 49 patients and malignancy in 169; 55 rectum, 38 rectosigmoid and 61 sigmoid. 167 patients (76.5%) had a laparoscopic procedure, conversion rate was 8.2% (n = 18) and 33 patients (15.1%) had an open procedure. Median LOS was 7 days (IQR:5–10), [Lap vs open: 6 days (IQR: 4–9) vs 9 days (IQR:7–14.25)]. 100 stomata were formed including 88 loop stomas and 12 end colostomies (7.1%). There was one in-hospital mortality, and ten anastomotic leaks (4.8%). Eighty patients (36.7%) had complications and Clavien-Dindo (CD) classification was; CD1 n = 27, CD2 n = 28, CD3 n = 23 and CD4 n = 2. We identified discordance in 60% of the cases between pre-op radiological TN staging and post-op TN histology. Median LN yield was 22 (IQR: 16–29) and R1 resection rate was 4.1 % (7/169). Local recurrences were identified in 6 cases (3.7%), median time to LR was 11.8 months (IQR: 8.5–13.7) and 27 patients (17%) developed metastasis, median time to distant metastasis = 12 months (IQR: 6.5–23.1).

Conclusion
The results are in keeping with the ACPGBI standards of management of colorectal cancer. We propose prospective data collection for auditing outcomes of cancer patients and ensuring accuracy of data submitted to national bodies.

 

Rowe, A.K; Orel, J; Adderley, A; Samad, A; Javed, M.A.. (2021). Dissecting the outcomes of anterior resections in a high-volume center. Colorectal Disease. 23 (Suppl 1), 118-119

 

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