Two Cases of Delayed Anastomotic Leakage Caused by Bevacizumab

We report 2 cases of delayed anastomotic leakage caused by bevacizumab in colorectal cancer patients. The first case is a 78-year-old woman diagnosed with transverse colon cancer(cT4b[stomach, ileum]N1bM0, cStage Ⅲc)who underwent open extended right hemicolectomy, distal gastrectomy(R-Y)and partial ileal resection. Six months later multiple liver metastases were detected, and mFOLFOX+bevacizumab was conducted as first-line chemotherapy. Seven days after the completion of 3 courses, the leakage of gastro-jejunal anastomosis was observed. The second case is a 79-year-old man diagnosed with rectosigmoid cancer(cT3N2aM1a[liver], cStage Ⅳa)who underwent robot-assisted low anterior resection. CAPOX+bevacizumab was suspended after the completion of 3 courses due to a urinary tract infection and femoral neck fracture. Eighty-two days after the initiation of bevacizumab the patient appeared with leakage of the anastomotic site. Careful attention should be paid to the anastomotic site in patients who received bevacizumab after colorectal surgery.