Anastomotic leakage in operations for colorectal cancer results in morbidity and mortality.
However, it also increases the risk of local recurrence and worsens prognosis.
So a better understanding of risk factors for developing anastomotic leakage in colorectal cancer surgery is important to surgeons.
Dr Tsuyoshi Konishi and colleagues determined the incidence and risk factors for clinical anastomotic leakage after elective surgery for colorectal cancer.
The researchers conducted prospective surveillance of colorectal resections performed by a single surgeon in a university hospital from 2000 to 2004.
The outcomes of interest was clinical anastomotic leakage.
The research team examined 18 independent clinical variables by univariate and multivariate analyses.
|Clinical anastomotic leakage was found in 3% of patients|
|Journal of the American College of Surgeons|
A total of 391 patients undergoing elective operations for colorectal cancer were admitted to the program.
The team identified clinical anastomotic leakage in 3% patients.
Univariate and multivariate analyses showed that preoperative steroid use, and longer duration of operation were predictive of clinical anastomotic leakage.
The researchers also found that contamination was independently predictive of clinical anastomotic leakage.
There were no statistical differences in leakage rates between patients with and without covering stoma.
However, the team noted that all patients requiring reoperation for leakage were without covering stoma.
Dr Konishi's team concluded, “Preoperative steroid use, longer duration of operation, and contamination of the operative field were independent risk factors for developing clinical anastomotic leakage after elective resection for colorectal cancer.”
“Surgeons should be aware of such high-risk patients, which would help them to decide whether to create a diversion stoma during surgery.”