Background: Patients with rectal carcinoma undergoing total mesorectal excision (TME) have a lower recurrence rate with preoperative radiotherapy (RT). The aim of this study was to assess the side-effects in patients who had preoperative RT compared with those who did not receive it (because of palliative resections, advanced age or refusal).
Methods: From January 2001 to March 2003, 40 patients underwent resection and double-stapled anastomosis for rectal carcinoma. We compared 17 patients who received RT followed by resection and low rectal anastomosis, with 23 patients who did not have RT.
Results: After surgery 7/17 of the patients who had received RT developed anastomotic leaks. Anastomotic leakage was seen only once in the patients who did not have RT (41% v. 4%, p = 0.006). A protective stoma, which was performed in 11 patients in the RT group, did not prevent anastomotic leakage (4/11 leakage with stoma v. 3/6 leakage without stoma, p = 0.64). Median hospital stay was longer in the RT group (17.4 v. 13.7 days, p = 0.017). There was no difference in the number of minor postoperative complications between the two groups (24% v. 22%).
Conclusion: Compared with surgery alone, preoperative short-term RT increased the number of anastomotic leaks and hospital stay, whether or not a protective stoma was performed.