Low Anterior Resection for Rectal Cancer: A 5-Year Study at a National Referral Center

Abstract Background: Colorectal cancer is one of the most commonly diagnosed cancers in Indonesia. Low anterior resection (LAR) is the preferred surgical modality for rectal cancer because of its sphincter-preserving advantage. Objectives: To describe the clinical characteristics, anastomotic leakage rate, and in-hospital mortality among patients with rectal cancer undergoing LAR at a national referral hospital. Design: Retrospective cross-sectional study. Settings: Division of Digestive Surgery, Department of Surgery, Dr. Cipto Mangunkusumo General National Hospital, Jakarta, Indonesia. Materials and Methods: Medical records of patients with rectal cancer who underwent LAR between 2020 and 2024 were reviewed. Data included age, gender, body mass index (BMI), diabetes status, tumor stage, preoperative albumin level, surgical approach, and outcomes. Main Outcome Measures: Anastomotic leakage and in-hospital mortality rates. Sample Size: Ninety-five patients. Results: Of the 95 patients, 56% were male, and 76.8% were over 50 years old. Adenocarcinoma was the predominant histologic type (95.7%). A normal BMI was observed in 48% of patients, and 24% were underweight. Ten patients underwent additional procedures (four urological and six gynecological). Laparoscopic surgery was performed in 61% of patients, with 13 converted to open surgery. An ileostomy was created in 56% of patients. Diabetes mellitus was present in 25%, and 51% had preoperative hypoalbuminemia. Anastomotic leakage occurred in 14.7%, and in-hospital mortality was 9.5%. Conclusions: Patients undergoing LAR for rectal cancer at our institution presented with varied clinical profiles and comorbidities. Substantial rates of anastomotic leakage and mortality underscore the importance of comprehensive preoperative assessment and vigilant postoperative care. Limitations: This study was limited by its single-center, retrospective design, and no significant predictors were identified. Conflict of Interest: The authors declared no conflict of interest.