After-hours colorectal surgery: a risk factor for anastomotic leakage

Purpose This study aims to increase knowledge of colorectal anastomotic leakage by performing an incidence study and risk factor analysis with new potential risk factors in a Dutch tertiary referral center. Methods All patients whom received a primary colorectal anastomosis between 1997 and 2007 wer...

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Bibliographic Details
Published in:International journal of colorectal disease 2009-07, Vol.24 (7), p.789-795
Main Authors: Komen, Niels, Dijk, Jan-Willem, Lalmahomed, Zarina, Klop, Karel, Hop, Wim, Kleinrensink, Gert-Jan, Jeekel, Hans, Ruud Schouten, W, Lange, Johan F
Format: Article
Language:English
Subjects:
Adult
After-Hours Care
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - statistics & numerical data
Biological and medical sciences
Colorectal Surgery - adverse effects
Elective Surgical Procedures
Gastroenterology
Gastroenterology. Liver. Pancreas. Abdomen
Hepatology
Humans
Incidence
Internal Medicine
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Original
Original Article
Proctology
Risk Factors
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Treatment Outcome
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Summary:Purpose This study aims to increase knowledge of colorectal anastomotic leakage by performing an incidence study and risk factor analysis with new potential risk factors in a Dutch tertiary referral center. Methods All patients whom received a primary colorectal anastomosis between 1997 and 2007 were selected by means of operation codes. Patient records were studied for population description and risk factor analysis. Results In total 739 patients were included. Anastomotic leakage (AL) occurred in 64 (8.7%) patients of whom nine (14.1%) died. Median interval between operation and diagnosis was 8 days. The risk for AL was higher as the anastomoses were constructed more distally (p = 0.019). Univariate analysis showed duration of surgery (p = 0.038), BMI (p = 0.001), time of surgery (p = 0.029), prophylactic drainage (p = 0.006) and time under anesthesia (p = 0.012) to be associated to AL. Multivariate analysis showed BMI greater than 30 kg/m² (p = 0.006; OR 2.6 CI 1.3-5.2) and “after hours” construction of an anastomosis (p = 0.030; OR 2.2 CI 1.1-4.5) to be independent risk factors. Conclusion BMI greater than 30 kg/m² and “after hours” construction of an anastomosis were independent risk factors for colorectal anastomotic leakage.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-009-0692-4