DIFFERENCE IN PREDICTORS OF ANASTOMOTIC LEAKAGE DEPENDING ON THE LEVEL OF ANASTOMOSIS AFTER COLORECTAL CANCER SURGERY/RAZLIKE U PREDIKTORIMA DEHISCENCIJA ANASTOMOZE NAKON OPERACIJE KOLOREKTALNOG KARCINOMA OVISNO O RAZINI ANASTOMOZE

• Published in: Acta clinica Croatica (Tisak) 2021-09, Vol.60 (3), p.341
• Main Authors: Jasarovic, Damir, Stojanovic, Dragos, Mitrovic, Nebojsa, Stevanovic, Dejan, Lazic, Aleksandar
• Format: Article
• Language: English
• Subjects: Care and treatment; Colorectal cancer; Colorectal surgery; Complications; Complications and side effects; Ileoanal anastomosis; Methods; Surgery
• ISSN: 0353-9466
• DOI: 10.20471/acc.2021.60.03.01

Anastomotic leak (AL) after colorectal cancer surgery is one of the most serious postoperative complications which has major impact on outcomes. The aim of this study was to investigate preoperative and intraoperative risk factors for AL, as well as to examine whether there are differences in risk factors for AL depending on the primary tumor location. We retrospectively reviewed records of patients having undergone colorectal surgical procedures for malignancies between January 2013 and December 2017 in a single institution. Only procedures with primary anastomosis were included. Of the 153 patients, AL occurred in 10.6% of patients with primary tumor in the sigmoid colon and rectum, and in 8.2% of patients with primary tumor in the proximal sections of the colon. On univariate analysis, delayed oral intake and more advanced histologic stages of the tumor were significantly correlated with AL in patients with tumors in the sigmoid colon and rectum, and multiorgan resection and distant metastases in patients with tumors in the proximal sections of the colon. In conclusion, risk factors for the occurrence of AL vary depending on the primary tumor location and further investigation is needed to provide better insight into these differences. Key words: Colorectal cancer; Anastomotic leak; Risk factors; Rectal cancer; Colon cancer Dehiscencija anastomoze (DA) nakon operacija karcinoma kolorektuma je jedna od najozbiljnijih poslijeoperacijskih komplikacija koja ima velik utjecaj na ishod lijecenja. Cilj ove studije bio je istraziti prijeoperacijske i intraoperacijske cimbenike rizika za DA, kao i ispitati postoje li razlike u cimbenicima rizika za DA ovisno o mjestu primarnog tumora. Retrospektivno smo analizirali podatke bolesnika podvrgnutih kirurskim zahvatima zbog kolorektalnog karcinoma na jednoj klinici u razdoblju od sijecnja 2013. do prosinca 2017. Ukljuceni su samo postupci s primarnim anastomozama. Od 153 bolesnika, DA se pojavila u 10,6% bolesnika s tumorom rektuma i sigmoidnog kolona te u 8,2% bolesnika s tumorom proksimalne lokalizacije. Univarijatna analiza je pokazala da su odgodeni pocetak peroralnog unosa te visi histoloski stadij tumora u znacajnoj korelaciji s DA u bolesnika s tumorom rektuma i sigmoidnog kolona, dok su multiorganska resekcija te udaljene metastaze u znacajnoj korelaciji s DA u bolesnika s tumorom proksimalne lokalizacije. Zakljuceno je da se cimbenici rizika za pojavu DA razlikuju ovisno o mjestu primarnog tumora pa su potre