Factors Leading to Post-Operative Leaks Following Bowel Anastomosis in a Tertiary Care Hospital: A Prospective Study

Abstract

BACKGROUNDThe goal of enteric anastomosis is to prevent leakage, to promote healing, to preserve bowel length, and to prevent stricture formation. An effective anastomosis requires adequate mobilization, perfusion, apposition, and inversion of the mucosal edges into the bowel lumen. METHODSAfter taking the institutional ethical committee approval for the study, the study was conducted at SVRRGG Hospital (a tertiary care centre of about 950 bed size), Tirupati. All patients were above 18 years and were admitted for undergoing gastrointestinal anastomoses electively. Patients who underwent gastrointestinal anastomoses as an emergency procedure in SVRRGG Hospital, Dept. of General Surgery, Tirupati from October 2017 to September 2018 were included in this study. RESULTSOut of the 60 cases in this study, 49 cases were done electively, and 11 cases were done on an emergency basis. The overall leak rate was 11.7%. The p-value is more than the significance level 0.05; the difference in leak rate between elective and emergency cases is not significant. CONCLUSIONSThis study is an attempt to evaluate various factors involved in bowel anastomotic leaks, various presentations of anastomotic leaks, and morbidity and mortality associated with them. With the observations and analysis, we concluded that various preoperative factors like haemoglobin %, nutritional status, serum albumin levels, intraoperative factors like degree of contamination, type of anastomosis and pathology involved have significant impact on outcome of bowel anastomosis.