[Anastomotic leakage following bowel resections for colon cancer: multivariate analysis of risk factors]

Chirurg. 2009 Dec;80(12):1153-9. doi: 10.1007/s00104-009-1725-9.
[Article in German]

Abstract

Background: The aim of this study was to evaluate the incidence and risk factors associated with anastomotic leakage after colon cancer surgery using data compiled in the nationwide German qualitative multi-center study "Colon/Rectum Cancer" (WGCRC).

Methods: From 01/01/2000 to 12/31/2004 data recorded from patients with anastomotic leakages were evaluated to determine independent predictors of leakage using logistic regression analysis.

Results: A total of 28,271 patients underwent colon resection with anastomoses and anastomotic leaks occurred in 3.0% (n=844). Multivariate analysis identified long duration of surgery, a high ASA score, male gender, obstruction, left-sided tumor, cardiovascular hepatic comorbidity, single-layer hand suture, anastomoses using the biofragmentable Valtrac ring, intraoperative complications and BMI>30 kg/m(2) as risk factors for postoperative occurrence of anastomotic leakage.

Conclusions: Even though the rate of anastomotic leaks in patients with anastomoses after resection for colon cancer is low, it remains a significant complication, associated with significant morbidity and mortality. The knowledge of risk factors should be considered in perioperative decision-making regarding anastomotic technique and indications for Hartmann's procedure.

Publication types

  • English Abstract
  • Multicenter Study

MeSH terms

  • Aged
  • Barium Sulfate
  • Body Mass Index
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / etiology*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / surgery*
  • Female
  • Germany
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Polyglycolic Acid
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Postoperative Complications / surgery*
  • Reoperation / mortality
  • Reoperation / statistics & numerical data
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Dehiscence / etiology*
  • Surgical Wound Dehiscence / mortality
  • Surgical Wound Dehiscence / surgery*
  • Surveys and Questionnaires
  • Survival Analysis
  • Suture Techniques / instrumentation

Substances

  • Valtrac
  • Barium Sulfate
  • Polyglycolic Acid