Clinical Factors Contributing to Anastomotic Leak After Mid-to-High Colorectal Anastomosis.


Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
Apr 2023
Historique:
medline: 5 6 2023
pubmed: 15 9 2021
entrez: 14 9 2021
Statut: ppublish

Résumé

Low colorectal anastomoses carry a high anastomotic leak (AL) rate (up to 20%) and thus are commonly diverted. Much less is known about mid-to-high colorectal anastomosis, which carries a leak rate of 2-4%. The objective of this study was to determine our AL rate after mid-to-high colorectal anastomosis and associated risk factors. A single center retrospective cohort study of patients undergoing left colonic resections with mid-to-high colorectal anastomosis (≥7 cm from the anal verge) from January 2008 to October 2017 was utilized. Main outcome, AL, defined as clinical suspicion supported by radiological or intraoperative findings, was calculated and risk factors assessed using multivariable logistic regression analysis. 977 patients were included; 487 (49.9%) were male, with a mean age of 59.8 (+/-12.1) years. Mean BMI was 27.5 (+/-5.5) kg/m Patients with mid-to-high colorectal anastomosis have a 2% AL risk. Increased BMI was a risk factor for AL.

Sections du résumé

BACKGROUND BACKGROUND
Low colorectal anastomoses carry a high anastomotic leak (AL) rate (up to 20%) and thus are commonly diverted. Much less is known about mid-to-high colorectal anastomosis, which carries a leak rate of 2-4%. The objective of this study was to determine our AL rate after mid-to-high colorectal anastomosis and associated risk factors.
METHODS METHODS
A single center retrospective cohort study of patients undergoing left colonic resections with mid-to-high colorectal anastomosis (≥7 cm from the anal verge) from January 2008 to October 2017 was utilized. Main outcome, AL, defined as clinical suspicion supported by radiological or intraoperative findings, was calculated and risk factors assessed using multivariable logistic regression analysis.
RESULTS RESULTS
977 patients were included; 487 (49.9%) were male, with a mean age of 59.8 (+/-12.1) years. Mean BMI was 27.5 (+/-5.5) kg/m
CONCLUSIONS CONCLUSIONS
Patients with mid-to-high colorectal anastomosis have a 2% AL risk. Increased BMI was a risk factor for AL.

Identifiants

pubmed: 34519249
doi: 10.1177/00031348211041555
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

778-783

Auteurs

Amandeep Ghuman (A)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Ramarao Ganga (R)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Natalia Parisi Severino (N)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Dimitri Krizzuk (D)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Qiong Zhen Li (QZ)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Steven D Wexner (SD)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

Giovanna Da Silva (G)

Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.

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