Transrectal Vacuum Assisted Drainage: A New Method of Treating Anastomotic Leakage After Rectal Resection

Inclusion Criteria: * Patients with clinically significant\* anastomotic leakage after intended curative rectal resection (LAR) for rectal cancer with primary anastomosis. * Patients whose operation did not include ileostomy must have surgery to create a stoma within two days after beginning of the vacuum therapy and before randomization. Anastomotic leakage must have been diagnosed within 21 days of the primary operation. * Patients with and without preoperative radiation therapy may participate. * Groups will be formed accordingly, because patients who had preoperative radiation therapy heal more slowly. * Patients with anastomotic leakage (diagnosed by endoscopic or radiology techniques) and clinical signs and symptoms indicating a health impairment (fever, pain, elevated creatinine levels). * Anastomotic leakage after rectal cancer surgery Exclusion Criteria: * Informed consent * Age \< 18 years * Acute surgery * Leakage diagnosed more than 21 days after the primary operation * Patient does not consent to temporary ileostomy * Anastomosis technically inaccessible for vacuum-assisted drainage * Small intestine visible in abscess cavity * Residual cancer tissue in the pelvic cavity * Suspicion of fistulation between the abscess cavity and internal genitalia, urinary tract system, or small intestines.