BACKGROUND: Anastomotic leaks are a serious complication of bowel surgery. This study aimed to evaluate the rate and severity, and identify risk factors for leaks in patients undergoing bowel anastomoses. METHODS: Prospective evaluation was performed on patients undergoing bowel surgery within a colorectal surgical unit. Anastomotic leak was defined and graded according to severity. A nurse independently collected the information. Stepwise logistic regression analysis was performed. RESULTS: Two thousand three hundred and sixty-three patients underwent 2994 anastomoses. Their median age was 64 years. Seven per cent were emergency operations. Anastomotic leak occurred in 82 patients (2.7%). Sixty-three per cent of leaks were managed with drainage or re-operation. Ultra-low anterior resection (ULAR) was associated with the highest subgroup leak rate (7.3%). In multivariable analysis, independent predictors for a leak included 'other' pathologies (iatrogenic injury, ischaemia, radiation enteritis) (P=0.016, odds ratio (OR): 6.3, 95% confidence interval (CI): 1.4-28.0), ULAR (P=0.001, OR: 8.5, 95% CI: 2.3-31.2) and the surgeon (A: P<0.001, OR: 3.4, 95% CI: 2.1-5.6). CONCLUSION: Majority of predictors for anastomotic leak were fairly intuitive. Nonetheless, it was relevant to note the importance of the individual surgeon as an independent predictor for leaks.
BACKGROUND:Anastomotic leaks are a serious complication of bowel surgery. This study aimed to evaluate the rate and severity, and identify risk factors for leaks in patients undergoing bowel anastomoses. METHODS: Prospective evaluation was performed on patients undergoing bowel surgery within a colorectal surgical unit. Anastomotic leak was defined and graded according to severity. A nurse independently collected the information. Stepwise logistic regression analysis was performed. RESULTS: Two thousand three hundred and sixty-three patients underwent 2994 anastomoses. Their median age was 64 years. Seven per cent were emergency operations. Anastomotic leak occurred in 82 patients (2.7%). Sixty-three per cent of leaks were managed with drainage or re-operation. Ultra-low anterior resection (ULAR) was associated with the highest subgroup leak rate (7.3%). In multivariable analysis, independent predictors for a leak included 'other' pathologies (iatrogenic injury, ischaemia, radiation enteritis) (P=0.016, odds ratio (OR): 6.3, 95% confidence interval (CI): 1.4-28.0), ULAR (P=0.001, OR: 8.5, 95% CI: 2.3-31.2) and the surgeon (A: P<0.001, OR: 3.4, 95% CI: 2.1-5.6). CONCLUSION: Majority of predictors for anastomotic leak were fairly intuitive. Nonetheless, it was relevant to note the importance of the individual surgeon as an independent predictor for leaks.
Authors: Bodil Gessler; David Bock; Hans-Christian Pommergaard; Jakob Burcharth; Jacob Rosenberg; Eva Angenete Journal: Int J Colorectal Dis Date: 2016-02-12 Impact factor: 2.571
Authors: Vahagn C Nikolian; Neil S Kamdar; Scott E Regenbogen; Arden M Morris; John C Byrn; Pasithorn A Suwanabol; Darrell A Campbell; Samantha Hendren Journal: Surgery Date: 2017-02-21 Impact factor: 3.982
Authors: A Pfahl; G K Radmacher; H Köhler; M Maktabi; T Neumuth; A Melzer; I Gockel; C Chalopin; B Jansen-Winkeln Journal: Biomed Opt Express Date: 2022-04-29 Impact factor: 3.562
Authors: Anthony Nagib; Chauniqua Kiffin; Eddy H Carrillo; Andrew A Rosenthal; Rachele J Solomon; Dafney L Davare Journal: Case Rep Surg Date: 2018-09-16