• Reem Alharbi, Osama Almosallam, Sara Albastaki, Asim Almughamsi, and Nasser Alsanea.
• From the Department of Clinical Sciences, College of Medicine, Princess Nourah bint Abdulrahman University, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2024 May 1; 44 (3): 135140135-140.

BackgroundAnastomotic leakage (AL) represents a severe complication after rectal surgery, leading to significant morbidity, mortality, and increased healthcare costs. Despite improvements in surgical methods and perioperative care, the challenge of AL persists.ObjectivesExplore the impact of body mass index (BMI) on the risk of AL following curative treatment for rectal cancer, providing insight into its predictive value.DesignRetrospective review.SettingsData were collected from a single tertiary center, emphasizing the specialized postoperative outcomes in a high-care setting.Patients And MethodsThe study population was comprised patients who underwent sphincter-saving surgery combined with neoadjuvant chemoradiation for rectal cancer from 2001 to 2011. Patients with anastomotic stenosis were excluded.Main Outcome MeasuresThe primary outcome investigated was the occurrence of AL post-surgery. Secondary outcomes included the assessment of local cancer recurrence rates within the AL group.Sample Size224; 13 excluded.ResultsOf 237 patients who underwent surgery, 13 with anastomotic stenosis were excluded from this study. Of the remaining 224, 15 individuals (6.3%) developed AL. A potential association between higher BMI and increased AL risk was identified. Additionally, the study noted a higher incidence of local rectal cancer recurrence in the group that developed leakage.ConclusionThe findings suggest BMI as a significant predictive factor for AL after curative rectal cancer treatment. This emphasizes the need for heightened awareness and possible preoperative counseling for obese patients regarding their increased risk of postoperative leakage.LimitationsThe study was retrospective with all the inherit biases of such studies. The sample size was small and this may have introduced a type 2 statistical error.

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