Risk factors for leak, complications and mortality after ileocolic anastomosis: comparison of two anastomotic techniques

Abstract

Introduction There are no definitive data concerning the ideal configuration of ileocolic anastomosis. Aim of this study was to identify perioperative risk factors for anastomotic leak and for 60-day morbidity and mortality after ileocolic anastomoses (stapled vs handsewn). Materials and methods This is a STROBE-compliant study. Demographic and surgical data were gathered from patients with an ileocolic anastomosis performed between November 2010 and September 2016 at a tertiary hospital. Anastomoses were performed using standardised techniques. Independent risk factors for anastomotic leak, complications and mortality were assessed. Results We included 477 patients: 53.7% of the anastomoses were hand sewn and 46.3% stapled. Laterolateral anastomosis was the most common configuration (93.3%). Anastomotic leak was diagnosed in 8.8% of patients and 36 were classified as major anastomotic leak (7.5%). In the multivariate analysis, male sex (P = 0.014, odds ratio, OR, 2.9), arterial hypertension (P = 0.048, OR 2.29) and perioperative transfusions (P < 0.001, OR 2.4 per litre) were independent risk factors for major anastomotic leak. The overall 60-day complication rate was 27.3%. Male sex (31.3% vs female 22.3%, P = 0.02, OR 1.7), diabetes (P = 0.03 OR 2.0), smoking habit (P = 0.04, OR 1.8) and perioperative transfusions (P < 0.001, OR 3.3 per litre) were independent risk factors for postoperative morbidity. The 60-day-mortality rate was 3.1% and no significant risk factors were identified. Conclusion Anastomotic leak after ileocolic anastomosis is a relevant problem. Male sex, arterial hypertension and perioperative transfusions were associated with major anastomotic leak. Conversion to open surgery was more frequently associated with perioperative death.

Risk Factor Analysis for Anastomotic Leakage after Lower Rectal Cancer Resection: A Retrospective Single-Center Study

“…However, other studies have found that diabetes was not a risk factor for anastomotic leakage [16,28]. [29]. These results were consistent with our underlying disease results, which suggested that the presence of underlying disease was associated with anastomotic leakage.…”

Analysis of Risk Factors for Anastomotic Leakage after Lower Rectal Cancer Resection, Including Drain Type: A Retrospective Single-Center Study

“…The overall 60-day complication rate in that study was 27.3%. Male sex (31.3% complication rate vs 22.3% among female patients, P = 0.0200, OR: 1.7), diabetes (P = 0.0300, OR: 2.0), smoking habit (P = 0.0400, OR: 1.8), and perioperative transfusion (P < 0.0010, OR: 3.3 per liter) were independent risk factors for postoperative morbidity [29]. These results are consistent with our underlying disease results, which suggest that the presence of underlying disease is associated with anastomotic leakage.…”

Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study

“…In this study, the overall 60-day complication rate in that study was 27.3%. The complication rate was 31.3% in male vs. 22.3% among female patients (P = 0.020, OR: 1.7), diabetes (P = 0.030, OR: 2.0), smoking habit (P = 0.040, OR: 1.8), and perioperative transfusion (P < 0.001, OR: 3.3 per liter) were independent risk factors for postoperative morbidity [26]. These results are consistent with our underlying disease results, which suggest that the presence of the underlying disease is associated with anastomotic leakage.…”