• P Matthiessen, M Henriksson, O Hallböök, E Grunditz, B Norén, and G Arbman.
• Department of Surgery, Orebro University Hospital, Orebro, Sweden. peter.matthiessen@orebroll.se
• Colorectal Dis. 2008 Jan 1; 10 (1): 75-80.

ObjectiveThis prospective study investigated the factors which might indicate anastomotic leakage after low anterior resection.MethodThirty-three patients who underwent anterior resection for rectal carcinoma (n = 32) and severe dysplasia (n = 1), were monitored daily by serum C-reactive protein (CRP) and white blood cell count (WBC) estimations until discharge from hospital. Computed tomography (CT) scans were performed on postoperative days 2 and 7 and the amount of presacral fluid collection was assessed. All patients had a pelvic drain and the volume of drainage was measured daily.ResultsThe level of the anastomosis was at a median 5 cm (3-12 cm) above the anal verge. There was no 30-day mortality. Nine (27.2%) of the 33 patients developed a symptomatic anastomotic leakage which was diagnosed at a median of 8 days (range 4-14) postoperatively. The serum CRP was increased in patients who leaked from postoperative day 2 onwards (P = 0.004 on day 2; P < 0.001 on day 3-8). The WBC was decreased in preoperatively irradiated patients on days 1-5 (P

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