• Annezo Marinatou, George E Theodoropoulos, Styliani Karanika, Theodoros Karantanos, Spiridon Siakavellas, Basileios G Spyropoulos, Konstantinos Toutouzas, and George Zografos.
• Colorectal Unit, First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece.
• Dis. Colon Rectum. 2014 Feb 1;57(2):158-66.

BackgroundAnastomotic leaks after colorectal resections for cancer are a leading cause of postoperative morbidity, mortality, and long hospital stay. Few data exist on the potentially deleterious effect of the anastomotic leaks after proctectomy for cancer on patient health-related quality of life.ObjectiveThe aim of this study was to explore the effect of clinically evident anastomotic leaks on health-related quality of life after rectal cancer excision.DesignThis is a case-matched study.SettingsThis study was conducted in a Greek academic surgical department.PatientsIncluded were 25 patients undergoing low anterior resection complicated by an anastomotic leak (Clavien classification II, n = 14, and III, n = 11) and 50 patients undergoing low anterior resection with an uncomplicated course.Main Outcome MeasuresHealth-related quality-of-life data were prospectively collected at fixed assessment time points (baseline, 3, 6, and 12 months postoperatively) by the use of validated questionnaires (Medical Outcomes Study Short Form 36, Gastrointestinal Quality of Life Index, European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-C30, and European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-CR29).Results"Leak" patients required a longer hospitalization. Although the numbers of initially constructed defunctioning loop ileostomies were not significantly different between cases and controls, "leak" patients were required to remain with a stoma significantly more often at all postoperative assessment time points. No differences were observed in the baseline scores between the 2 groups. Physical function of "leak" patients was significantly worse at all postoperative assessment time points. At 6 and 12 months, their emotional and social function and overall quality-of-life scores were significantly decreased in comparison with the patients with an uncomplicated course. "Leak" patients experienced significantly more "stoma-related problems" and "sore skin" around the stoma site.LimitationsLimited number of patients, restriction of follow-up to the end of the first year, and heterogeneity in terms of the presentation, severity, and management of anastomotic leaks were the limitations of this study.ConclusionsAnastomotic leaks have an adverse effect on postoperative health-related quality of life.

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