Gastrointestinal anastomoses. Factors affecting early complications.

A retrospective review of gastric and colonic anastomoses during a recent 12-month period was performed at the Mayo Clinic. One hundred sixty-nine patients had gastroduodenal or gastrojejunal anastomoses (Group I). Five hundred nineteen patients had ileocolonic or ileorectal (222) and colocolonic or colorectal (297) anastomoses (Group II). Major anastomotic complication rates for Group I patients were: leaks, 1%; hemorrhage, 2%; and stenosis or obstruction, 2%. Reoperations and deaths secondary to anastomotic complications during the postoperative period were 2% and 0.6%, respectively. Corresponding rates for Group II were 2%, 1%, and 4%, with reoperative and anastomotic death rates of 1% and 0.2%, respectively. In Group I patients, length of operation had a significant effect (p less than 0.01) on anastomotic complications. In Group II patients, a significant increase in complications was related to the presence of obstruction (p less than 0.001), recent weight loss (greater than 10 pounds) (p less than 0.02), malignancy (p less than 0.04), and sepsis (p less than 0.05).