Martin Rutegård

 

ImageMattias Pettersson

Surgical technique and complications in rectal cancer surgery

A major problem in rectal cancer surgery consists of anastomotic breakdown and leakage with a markedly increased risk of mortality. Moreover, anastomotic leakage causes long-term bowel dysfunction and often leads to a permanent stoma, as well a risk of cancer recurrence.

One way of reducing the leak rate is to fashion a temporary diverting stoma; however, these are not always reversed and may become permanent stomas.

We approach these problems by trying to identify new preoperative serological biomarkers in the U-CAN biobank project, with the aim of classifying patients as prone to leaks or not; moreover, we analyse postoperative samples to investigate whether proteins related to inflammation or angiogenes might mediate the elevated risk of recurrence in leak patients. These proteins are also evaluated in conjunction with rectal perfusion data in a clinical cohort.

In addition, we investigate the merits of temporary stomas using nationwide registries, informing the surgeon when to use such diversion.