AIM: To examine modifiable risk factors for anastomotic leak in patients undergoing low anterior resection. METHOD: In total 233 patients undergoing low anterior resection for benign and malignant disease over a 10-year period at a single surgical unit were identified from a prospective database. The relationships between anastomotic leak and 17 variables were examined, including patient demographics, operative technique, tumour pathology, preoperative physiological function and smoking status. RESULTS: The majority (91%) of operations were carried out for rectal cancers, and 24 procedures (10%) were performed with laparoscopic assistance. The overall anastomotic leak rate was 14% (33/233). Patients with anastomotic leak had higher 30-day mortality (6%vs 1%, P<0.05) and stayed significantly longer in hospital (median 23 vs 10 days, P<0.001). On multivariate analysis, current smokers (OR 3.68, 95% CI 1.38-9.82, P=0.009) and patients with evidence of metastatic malignant disease (OR 3.43, 95% CI 1.29-9.13, P=.013) were at increased risk of anastomotic leak. CONCLUSION: Smoking and the presence of metastatic disease are major risk factors for the development of anastomotic leak following low anterior resection.
AIM: To examine modifiable risk factors for anastomotic leak in patients undergoing low anterior resection. METHOD: In total 233 patients undergoing low anterior resection for benign and malignant disease over a 10-year period at a single surgical unit were identified from a prospective database. The relationships between anastomotic leak and 17 variables were examined, including patient demographics, operative technique, tumour pathology, preoperative physiological function and smoking status. RESULTS: The majority (91%) of operations were carried out for rectal cancers, and 24 procedures (10%) were performed with laparoscopic assistance. The overall anastomotic leak rate was 14% (33/233). Patients with anastomotic leak had higher 30-day mortality (6%vs 1%, P<0.05) and stayed significantly longer in hospital (median 23 vs 10 days, P<0.001). On multivariate analysis, current smokers (OR 3.68, 95% CI 1.38-9.82, P=0.009) and patients with evidence of metastatic malignant disease (OR 3.43, 95% CI 1.29-9.13, P=.013) were at increased risk of anastomotic leak. CONCLUSION: Smoking and the presence of metastatic disease are major risk factors for the development of anastomotic leak following low anterior resection.
Authors: A Arezzo; M Migliore; P Chiaro; S Arolfo; C Filippini; D Di Cuonzo; R Cirocchi; M Morino Journal: Tech Coloproctol Date: 2019-06-25 Impact factor: 3.781
Authors: Nicholas P McKenna; Katherine A Bews; Robert R Cima; Cynthia S Crowson; Elizabeth B Habermann Journal: J Gastrointest Surg Date: 2019-06-26 Impact factor: 3.452
Authors: Eva Bjerre Ostenfeld; Rune Erichsen; John A Baron; Ole Thorlacius-Ussing; Lene Hjerrild Iversen; Anders H Riis; Henrik Toft Sørensen Journal: BMJ Open Date: 2015-09-24 Impact factor: 2.692