Aim: The risk of anastomotic leakage after colorectal cancer surgery is higher in men, regardless of the anatomical location. Previous studies suggest that this might be due to hormonal differences. The aim of this work was to investigate whether androgen deprivation therapy influenced the incidence of anastomotic leakage.

Method: This is a nationwide registry-based study of men operated on between 2007 and 2021 for colorectal cancer with an anastomosis. Exposure to androgen deprivation therapy (prescribed drugs or surgical castration) was related to anastomotic leakage using mixed-effects logistic regression models. Two control groups were formed: one without and one with prostate cancer but without androgen deprivation. To study the potential target for androgen effect in intestinal tissue, androgen receptor expression was evaluated using immunohistochemistry in a smaller independent cohort to compare receptor expression in relation to leakage.

Results: Some 24 611 men were included in the registry study, of whom 2.4% were exposed to androgen deprivation therapy. In this exposed group, compared with unexposed men with and without prostate cancer, respectively, leak rates were 3.7%, 5.6% and 5.8%, respectively. After adjustment, a nonsignificant reduction of anastomotic leakage in the exposed group was detected (OR 0.70, 95% CI 0.45-1.09) compared with men without prostate cancer. Tissue expression of androgen receptor was very low among patients with and without leakage, albeit with a trend of higher expression among the latter.

Conclusion: Anastomotic leakage rates might be lower in men exposed to androgen deprivation therapy before surgery for colorectal cancer, although this finding must be interpreted cautiously. Effects on anastomotic healing do not seem to be mediated through classical androgen receptor signalling in the intestine.

Keywords: anastomosis; hormones; leak; men; operation; receptor.

© 2025 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

目的： 男性在结直肠癌手术后吻合口漏的风险较高，无论解剖位置如何。以往的研究表明这可能是由于激素差异所致。本研究旨在调查雄激素剥夺治疗是否影响了吻合口漏的发生率。

方法： 这是一个基于全国注册的队列研究，研究对象为2007年至2021年间因结直肠癌进行吻合手术的男性。通过混合效应逻辑回归模型将雄激素剥夺治疗（包括处方药物或外科去势）与吻合口漏相关联。建立了两个对照组：一组无前列腺癌且未接受雄激素剥夺治疗，另一组有前列腺癌但未接受雄激素剥夺治疗。为了研究雄激素在肠组织中的潜在作用靶点，使用免疫组织化学评估了小型独立队列中雄激素受体的表达，并比较了与漏相关的受体表达。

结果： 注册研究纳入约24,611名男性，其中2.4%的人接受了雄激素剥夺治疗。在该暴露组中，分别与未接受治疗有无前列腺癌的男性相比，漏的发生率分别为3.7%，5.6%和5.8%。调整后，在接受治疗的群体中检测到吻合口漏非显著减少（OR 0.70, 95% CI 0.45-1.09），与无前列腺癌的男性相比。患者有无漏，组织中的雄激素受体表达都很低，尽管后者有所上升的趋势。

结论： 在接受结直肠癌手术前接受雄激素剥夺治疗的男性的吻合口漏率可能较低，但这一发现必须谨慎解释。对吻合口愈合的影响似乎不是通过经典的雄激素受体信号传导在肠道中进行。

关键词： 吻合；激素；漏；男性；手术；受体。