1 . 2021

Risk factors for colorectal anastomotic leakage: retrospective study

Abstract

Background. Anastomosis between the colon and rectum is a particularly high risk. Anastomotic leakage is associated with high morbidity and mortality, and increased hospital duration of stay. Unfortunately, it still occurs too frequently.

The aim of this study was to evaluate the risk factors for anastomotic leakage after left-sided colorectal surgery.

Material and methods. This study was a retrospective, single-institution study of 74 cancer patients who underwent left-sided colorectal surgery between December 2015 and June 2020. The general information, perioperative outcomes, and comorbidities were collected. Univariate and multivariable Cox regression analyses were used to determine independent risk factors associated with anastomotic leakage.

Results. 74 patients were included in the study: 43 males and 31 females, with a median age of 62 years (range - 39-88 years). The median tumor distance from the anal verge was 11 cm (range - 1-28 cm). Symptomatic anastomotic leakage occurred in 7 (9.5%) patients. Among the pre- and intraoperative factors, leakage was significantly associated with age ≥70, distance from the anal verge (5-10 cm), CLS (Colon Leakage Score) (≥10) and technique of surgery (laparoscopic) in univariate analysis. In multivariate analysis, distance from the anal verge from 5 to 10 cm (p=0.021; F=5.544; 95% CI 0.438-0.822) and CLS >≥10 (p=0.026; F=5.198; 95% CI 0.594-0.973) were identified as predictive factors for anastomotic leakage.

Conclusion. In this study, distance from the anal verge from 5 to 10 cm and CLS ≥10 were independent early predictive factors for anastomotic leakage.

Keywords:colorectal cancer, anastomotic leakage, risk factors of anastomotic leakage

Funding. The study had no sponsor support.
Conflict of interests. The authors declare no conflict of interests.
For citation: Polishchuk L.O., Vetshev F.P., Petrenko K.N., Sumbaev A.A., Bedzhanyan A.L. Risk factors for colorectal anastomotic leakage: retrospective study. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (1): 37-44. DOI: https://doi.org/10.33029/2308-1198-2021-9-1-37-44 (in Russian)

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