Anastomotic leaks in colorectal surgery. Issue 10 (24th January 2014)

• Record Type: Journal Article
• Authors: Damen, Nikki; Spilsbury, Katrina; Levitt, Michael; Makin, Gregory; Salama, Paul; Tan, Patrick; Penter, Cheryl; Platell, Cameron
• Is Part Of: ANZ journal of surgery. Volume 84:Issue 10(2014)
• Page Start: 763
• Page End: 768
• Publication Date: 2014-01-24
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.12494
• Languages: English
• ISSNs: 1445-1433

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ans12494-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="ans12494-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ans12494-sec-0003" sec-type="section"> <title>Results</title> <p>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) (<italic>P</italic> = 0.016, odds ratio (OR): 6.3, 95% confidence interval (CI): 1.4–28.0), ULAR (<italic>P</italic> = 0.001, OR: 8.5, 95% CI: 2.3–31.2) and the surgeon (A: <italic>P</italic> < 0.001, OR: 3.4, 95% CI: 2.1–5.6).</p> </sec> <sec id="ans12494-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>