Objective: This study aimed to assess a radiologic test and clinical findings as risk factors of chronic complications after anastomotic leakage (CCAL) in rectal surgery.Summary of Background Data: Anastomotic leakage (AL) is the most important complication that is related to chronic complications like unhealed chronic sinuses, strictures, and infections.Methods: This retrospective study included patients who developed anastomotic leakage (AL) after undergoing extraperitoneal anastomosis. Patients with the following characteristics were excluded: (1) patients with no anastomoses, (2) patients undergoing multiple resections due to synchronous colorectal lesions, (3) patients with no curative resections of the primary lesions, and (4) patients experiencing immediate postoperative mortality. Finally, 72 patients were analyzed in this study. The patients were divided into the no chronic complication (NCC) group and the chronic complication (CC) group.Results: Of the 72 included patients, 17 (23.6%) had CCAL. The patients in the CC group more frequently had radiotherapy and lower tumor compared to the patients in the NCC group. A total of 52 (52/55 [94.5%]) and 4 patients (4/17 [23.5%]) in the NCC group and the CC group achieved bowel continuity 3 years after the primary surgery, respectively (p < 0.0001). According to the multivariate analysis, CT findings at the 6th postoperative month and tumor height were associated with CCAL (p < 0.0001 and p = 0.046, respectively).Conclusion: This study showed that CT findings at the 6th postoperative month and tumor height were possibly associated with CCAL.

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