TY - JOUR
AR - SCR-2021-9-112
TI - Delayed Anastomotic Failure After Chemoradiation: A Delay in Diagnosis or Late Presentation? - A Case Series
AU - Michael Thomas, Scott
AU - Shahyan Ur, Rehman
AU - June, Hsu
AU - Nell Maloney, Patel
JO - Surgical Case Reports
PY - 2021
DA - Thu 30, Sep 2021
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2021.09.12
UR - https://www.sciencerepository.org/delayed-anastomotic-failure_SCR-2021-9-112 
KW - Anastomotic leak, colorectal surgery, chemoradiation, cancer, case report
AB - Anastomotic leak after colorectal surgery can result in serious morbidity for certain patients. The rate of clinically significant anastomotic leak after colon resection ranges from 1.8% to 11.9%. Risk factors include male sex, steroids, smoking, perioperative blood transfusion, malnutrition, and a low anastomosis. However, the effect of pre-operative chemoradiation therapy (CRT) on rates of anastomotic leak is controversial. Specifically, late leaks, which are defined as those that occur greater than 30 days after surgery, are sparsely described in current literature. Recent evidence suggests that CRT may contribute to the presentation of late anastomotic leaks. In this case series, we report our experience with three patients who received CRT and developed varying presentations of a late anastomotic leak. Therefore, our experience supports the consideration of late anastomotic leaks as a separate entity in colorectal surgery. While pre-operative CRT may increase risk for postoperative anastomotic leak overall, further exploration into the relationship between preoperative CRT and late anastomotic leaks is warranted.