A nationwide study on anastomotic leakage after colonic cancer surgery

• Published in: Colorectal disease 2012-10, Vol.14 (10), p.e661-e667
• Main Authors: Krarup, P.-M., Jorgensen, L. N., Andreasen, A. H., Harling, H.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - surgery; Adult; Age Factors; Aged; Aged, 80 and over; Anastomotic Leak - epidemiology; Anastomotic Leak - etiology; Anastomotic leakage; Blood Loss, Surgical; Blood Transfusion; Cohort Studies; Colectomy - methods; colon; Colonic Neoplasms - surgery; Databases, Factual; Denmark; Female; Humans; Incidence; Laparoscopy; Logistic Models; Male; Middle Aged; Multivariate Analysis; nationwide; Prospective Studies; Risk Factors; Sex Factors
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2012.03079.x

Aim  Anastomotic leakage (AL) is a major challenge in colorectal cancer surgery due to increased morbidity and mortality. Possible risk factors should be investigated differentially, distinguishing between rectal and colonic surgery in large‐scale studies to avoid selection bias and confounding. Method  The incidence and risk factors associated with AL were analysed in an unselected nationwide prospective cohort of patient subjected to curative colonic cancer surgery with primary anastomosis and entered into The Danish Colorectal Cancer Group database between May 2001 and December 2008. Results  AL occurred in 593 (6.4%) of 9333 patients. Laparoscopic surgery [odds ratio (OR) 1.34; 95% confidence interval (CI) 1.05–1.70; P = 0.03); left hemicolectomy (OR 2.02; 95% CI 1.50–2.72; P = 0.01) or sigmoid colectomy (OR 1.69; 95% CI 1.32–2.17; P = 0.01); intra‐operative blood loss (OR 1.04; 95% CI 1.01–1.07; P = 0.03); blood transfusion (OR 10.27; 95% CI 6.82–15.45; P