The Medical, Oncological, Functional & Financial Cost of Anastomotic Leak
Steven D. Wexner, Chairman of the Department of Colorectal Surgery at Cleveland Clinic (Florida, USA) explains the effects of anastomotic leakage in terms of postoperative morbidity, as well as of functional, oncological and financial outcomes.
A thorough review of the short-term outcomes after an anastomotic leak reveals a cumulative length of stay that is 7 days longer for patients with anastomotic leakage compared to those without it. Anastomotic leakage also increases the post-operative infection rate, as well as the readmission, mortality (600% increase compared to patients with no anastomotic leak) and reoperation rates.
The functional outcomes after anastomotic leakage are also compromised, with an increase in day frequency, night frequency, and worse control of solids and pad use. Anastomotic leakage is also associated with a decrease in overall survival due to a decrease in long-term cancer-specific mortality and a increase in local recurrence.
From the financial point of view anastomotic leakage seems to be associated with a significant increase in costs, especially in patients without a diverting stoma.