scholarly journals Risk Factors for Anastomotic Leak Following Colorectal Surgery

2010 ◽  
Vol 145 (4) ◽  
pp. 371 ◽  
Author(s):  
Dana A. Telem
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leak

Risk Factors for Anastomotic Leak, Consideration for Proximal Diversion, and Appropriate Use of Drains

2021 ◽  
Vol 34 (06) ◽  
pp. 366-370
Author(s):  
Joanne Favuzza
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
High Risk ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Anastomotic Leaks ◽  
Appropriate Use ◽  
Preoperative Optimization ◽  
Colorectal Surgeons ◽  
Drain Placement

AbstractAnastomotic leaks are a major source of morbidity after colorectal surgery. There is a myriad of risk factors that may contribute to anastomotic leaks. These risk factors can be categorized as modifiable, nonmodifiable, and intraoperative factors. Identification of these risk factors allows for preoperative optimization that may minimize the risk of anastomotic leak. Knowledge of such high-risk features may also affect intraoperative decision-making regarding the creation of an anastomosis, consideration for proximal diversion, or placement of a drain. A thorough understanding of the interplay between risk factors, indications for proximal diversion, and utility of drain placement is imperative for colorectal surgeons.

scholarly journals Operative Management of Anastomotic Leaks after Colorectal Surgery

2019 ◽  
Vol 32 (03) ◽  
pp. 190-195 ◽  
Author(s):  
Nicole Saur ◽  
E. Paulson
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Surgical Techniques ◽  
Perioperative Period ◽  
Operative Management ◽  
Nonoperative Treatment ◽  
Operative Exploration ◽  
Operative Findings

AbstractAnastomotic leak is associated with increased morbidity and mortality after colorectal surgery. Although surgical techniques have improved over time, anastomotic leak is still a reality in colorectal surgery with rates ranging from as low as 1% for low-risk anastomoses, such as enteroenteric or ileocolic, to 19% for high-risk coloanal anastomoses. There are many varied risk factors for anastomotic leak. However, many of the risk factors have not been definitively proven in high-quality studies. Presumably, risk factors are cumulative and every effort should be made to optimize modifiable risk factors in the perioperative period. Treatment of anastomotic leak should start with the determination of patient stability followed by resuscitation and diagnostic imaging or operative exploration. Operative findings will dictate surgical approach with the goal of controlling sepsis and stabilizing the patient. If nonoperative treatment is undertaken, close patient monitoring is necessary to ensure control of sepsis and that intervention is undertaken if the clinical picture changes. Early intervention at each stage is key to decreasing the morbidity of anastomotic leak.

scholarly journals Anastomotic Leak after Colorectal Surgery. Our Experience in three Years.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Kastriot Haxhirexha ◽  
Agron Dogjani ◽  
Lutfi Zylbehari ◽  
Nehat Baftiu ◽  
Ferizat Dika – Haxhirexha
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Intestinal Resection ◽  
Morbidity And Mortality ◽  
Multiple Risk Factors ◽  
Four Quadrant ◽  
Emergent Surgery ◽  
Large Bowel Resection

Background: One of the most severe complication after intestinal resection, often with catastrophic consequence for the patient is leakage from the anastomosis. The severity of complications after anastomotic leak may range from a small localized peritonitis or abscess formation without sepsis, to a development of a four quadrant peritonitis with septic shock. Until now despite the seriousness of this complications, the cause of anastomotic leakage are not yet definitively clear. Aim: The aim of this study is to submit our experience in treatment of patients with anastomotic leakage after intestinal resection and their outcome. Materials and Methods: The study included 63 patients with colorectal cancer operated in the Department of Surgery at the Clinical Hospital of Tetova. In all patients intestinal resection with end to end anastomosis was performed. Conclusions: Anastomotic leak after large bowel resection is a very serious complication with a great impact on patient’s morbidity and mortality.  Multiple risk factors are associated with occurrence of this complication whereas the more suspected are: preoperative anaemia, hypoalbuminemia, emergent surgery without adequate preparation of patient, intraoperative blood loss and blood transfusion during surgery etc. Early detection of AL is very important and helpful to improve the outcome of patients and to minimize postoperative rate of morbidity and mortality. Keywords: anastomotic leaks, colorectal surgery, risk factors  

Anastomotic leak after colorectal surgery: does timing affect failure to rescue?

2021 ◽  
Author(s):  
Richard T. Spence ◽  
Dhruvin H. Hirpara ◽  
Sachin Doshi ◽  
Fayez A. Quereshy ◽  
Sami A. Chadi
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Failure To Rescue

A PROSPECTIVE ANALYSIS OF RISK FACTORS, PRESENTATION AND OUTCOME OF LEAKAGE AFTER GASTROINTESTINAL ANASTOMOSES

2021 ◽  
pp. 15-19
Author(s):  
Vikash Katiar ◽  
R.K. Jauhari ◽  
Abhinav Sengar ◽  
Vibhu Jain
Keyword(s):  
Risk Factors ◽  
Anastomotic Leak ◽  
Infectious Complications ◽  
Gastrointestinal Anastomosis ◽  
Albumin Concentration ◽  
Causative Factors ◽  
Preoperative Bowel Preparation ◽  
Surgical Duration ◽  
Mean Time ◽  
Ethical Clearance

Background: Despite advancements in modern surgery and postoperative care, disruption of gastrointestinal anastomosis remains the most dreaded complication, even in experienced surgical hands. The cause of leakage is multifactorial consisting of a complete spectrum of pre, intra and postoperative factors. Search for an ideal gastrointestinal anastomosis still remains an unquenched thirst. Study Design: Prospective, hospital based, time bound observational study. Methods: After ethical clearance, 288 consenting adult patients who underwent gastrointestinal anastomosis were observed for risk factors, presentation and outcome of leakage and evaluated using appropriate statistical tools. Results: An overall gastrointestinal anastomotic leak rate of 15.28% with peak incidence at 41-50 years (19.51%) was seen. Peritonitis (p=0.0009, OR=2.9611), COPD (p=0.0181, OR=2.7306), low serum albumin concentration (p=0.0028, OR=3.1442), ASA status of ≥III (p=0.0001, OR=4.0281) and a perioperative blood transfusion requirement of ≥2 units (p=0.0028, OR=3.1442) were the most signicant risk factors associated with leakage. Obstruction (p=0.0160, OR=2.2310), malignancy (p=0.0149, OR=2.6961), steroid therapy (p=0.0176, OR=2.2741), chemoradiation (p=0.0400, OR=2.4889), diabetes (p=0.0427, OR=2.2689), undernutrition (p= 0.0308, OR= 2.1099), anaemia (p=0.0325, OR=2.0183) and sepsis (p=0.0187, OR=2.2702) also showed clear risk augmentation. Risk of leakage was increased with a surgical duration of >4 hours (p=0.0078, OR=2.5610), when anastomosis was done as an emergency procedure (p=0.0427, OR=2.6571) or by a surgeon with expertise of ≤5 years (p=0.0338, OR=2.7733). Neither the level, type, technique of anastomosis; nor the usage of surgical staplers had an impact on leakage. Preoperative bowel preparation and creation of a proximal stoma also had minimal effect on leakage rates; though, the infectious complications that follow were greatly reduced. The most common presentation of anastomotic leak was a suspicious drain output with a mean time of 7.59± 2(2.48) postoperative days; resulting in a prolongation of hospitalization by more than ten days (p<0.0001), along with an increased mortality rate (p<0.0001). Conclusions: Accurately predicting anastomotic leakage still requires more evidence-based information. Even with good risk stratication, many causative factors may not be amenable to immediate correction in the pre-operative period. In such cases, the patient must be considered as a candidate for an enterostomy to help tide the crisis over.

Sign in / Sign up

Export Citation Format

Share Document