Dr Hok-Kwok Choi and colleagues from Hong Kong identified the risk factors associated with anastomotic leakage after an intraperitoneal large-bowel anastomosis.
The investigative team prospectively collected data of patients who underwent colorectal resection for malignancy between 1996 and 2004.
The patients also had primary anastomosis above the pelvic peritoneal reflection.
The investigators evaluated 35 variables using univariate and multivariate analysis.
The team studied a total of 1417 patients, and anastomotic leakage occurred in 25 patients.
|Risk of anastomotic leakage was 8% if both factors were present|
|Diseases of the Colon & Rectum|
The team found that 88% of patients required reoperation for anastomotic leakage.
The hospital stay, and mortality rate of patients with anastomotic leakage were significantly increased compared with those without leakage.
The investigators showed that American Society of Anesthesiologists Grade 3 to 5 was an independent factor associated with anastomotic leakage.
In addition, the team observed that an emergency operation was an independent factor associated with anastomotic leakage.
The risk of anastomotic leakage was 8% if both factors were present.
Dr Choi's team concludes, “Intraperitoneal anastomosis after large-bowel resection is associated with a low leakage rate.”
“Emergency surgery and a high American Society of Anesthesiologists grade are independent factors associated with an increased incidence of leakage.”
“A temporary diverting stoma to protect the primary anastomosis or even avoidance of anastomosis could be considered for patients with the 2 risk factors present.”