The patient perspective on colorectal anastomotic leaks: A qualitative study

AIM: Anastomotic leakage is a well-known complication following colorectal surgery, however, there is limited knowledge about patients' experiences with leaks across the care pathway, from initial diagnosis and treatment to long-term recovery. To explore patients' experiences of anastomotic leakage following colorectal resection and identify patient-reported priorities relevant to standardized reporting. METHODS: Qualitative descriptive study reported using the COnsolidated criteria for REporting Qualitative research. Online semi-structured interviews were conducted with patients from five countries (Australia, Canada, Netherlands, United Kingdom, and United States). Ten participants (six males, median age 53 [range 39-65 years]) who experienced an anastomotic leak following a colorectal resection. Themes and subthemes emerging from thematic analysis until saturation were reached. RESULTS: Four main themes were identified: (1) physical impact, (2) emotional impact, (3) coping mechanisms, and (4) anastomotic leak care. Within these themes, participants detailed their lived experience during the different phases of the care pathway: diagnosis, treatment, early and late recovery. Additionally, participants indicated the elements of anastomotic leak care that they deemed most important, including preoperative education, communication, support from medical staff and peers, sharing of information, aftercare, shared decision-making, and case management. CONCLUSIONS: Patients having experienced a colorectal anastomotic leak reported a physical and emotional impact, applied different coping strategies, and emphasized the importance of clear communication, comprehensive care, and sustained attention beyond the early postoperative and treatment phase.