Delayed Anastomotic Leakage After Bevacizumab Therapy in rectal Cancer Patient: A Case Report

Surgery, chemotherapy, and targeted agents play crucial roles in the treatment of colorectal cancer (CRC). Bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor used in metastatic CRC, has been associated with delayed wound healing, potentially increasing the risk of anastomotic leakage. In this case, a 71-year-old patient who underwent low anterior resection for rectal cancer developed delayed anastomotic leakage 26 months after surgery. Imaging revealed a presacral abscess and a collection communicating with the intestinal lumen, and surgical exploration confirmed anastomotic dehiscence. A diverting colostomy was performed, and the patient remained stable in the postoperative period. This case highlights that bevacizumab therapy can impact anastomotic integrity even in the late postoperative period, emphasizing the need for prolonged and careful follow-up in such patients.