[Anastomotic leakage following bowel resections for colon cancer: multivariate analysis of risk factors].

Abstract

BACKGROUND:

The aim of this study was to evaluate the incidence and risk factors associated with anastomotic leakage after colon cancer surgery using data compiled in the nationwide German qualitative multi-center study "Colon/Rectum Cancer" (WGCRC).

METHODS:

From 01/01/2000 to 12/31/2004 data recorded from patients with anastomotic leakages were evaluated to determine independent predictors of leakage using logistic regression analysis.

RESULTS:

A total of 28,271 patients underwent colon resection with anastomoses and anastomotic leaks occurred in 3.0% (n=844). Multivariate analysis identified long duration of surgery, a high ASA score, male gender, obstruction, left-sided tumor, cardiovascular hepatic comorbidity, single-layer hand suture, anastomoses using the biofragmentable Valtrac ring, intraoperative complications and BMI>30 kg/m(2) as risk factors for postoperative occurrence of anastomotic leakage.

CONCLUSIONS:

Even though the rate of anastomotic leaks in patients with anastomoses after resection for colon cancer is low, it remains a significant complication, associated with significant morbidity and mortality. The knowledge of risk factors should be considered in perioperative decision-making regarding anastomotic technique and indications for Hartmann's procedure.

• Authors: R Kube, P Mroczkowski, R Steinert, M Sahm, U Schmidt, I Gastinger, H Lippert
• Journal: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen (Chirurg) Vol. 80 Issue 12 Pg. 1153-9 (Dec 2009) ISSN: 1433-0385 [Electronic] Germany
• Vernacular Title: Anastomoseninsuffizienzen nach Kolonkarzinomresektionen : Multiple Analyse der Risikofaktoren.
• PMID: 19533064 (Publication Type: English Abstract, Journal Article, Multicenter Study)

Chemical References

• Valtrac
• Barium Sulfate
• Polyglycolic Acid

Topics

• Aged
• Barium Sulfate
• Body Mass Index
• Colonic Neoplasms (epidemiology, etiology, mortality, surgery)
• Female
• Germany
• Humans
• Logistic Models
• Male
• Middle Aged
• Polyglycolic Acid
• Postoperative Complications (epidemiology, etiology, mortality, surgery)
• Reoperation (mortality, statistics & numerical data)
• Risk Factors
• Surgical Wound Dehiscence (epidemiology, etiology, mortality, surgery)
• Surveys and Questionnaires
• Survival Analysis
• Suture Techniques (instrumentation)