Calcium score: a new risk factor for colorectal anastomotic leakage

Am J Surg. 2011 Jun;201(6):759-65. doi: 10.1016/j.amjsurg.2010.01.033. Epub 2010 Sep 27.

Abstract

Background: Anastomotic leakage (AL) is the most feared complication of colorectal surgery. Atherosclerosis is suggested to have a detrimental effect on anastomotic healing. This study aimed to analyze the calcium score, a measure for atherosclerosis, as a risk factor for AL.

Study design: The calcium scores of colorectal patients operated on in 2 Dutch university medical centers were determined using a computed tomography scan and calcium scoring software. The aorta, common iliac arteries, internal and external iliac arteries were studied. Additionally, patient- and operation-related factors were scored.

Results: A total of 122 patients were included. In patients with AL, calcium scores were significantly higher in the left common iliac artery (561.4 vs 156.0, P = .028), right common iliac artery (542.0 vs 144.4, P = .041), both common iliac arteries together (1,103.3 vs 301.9, P = .046), and the left internal iliac artery (716.3 vs 35.3, P = .044).

Conclusions: Patients with higher calcium scores in the iliacal arteries have an increased leakage risk.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Anastomosis, Surgical
  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / etiology*
  • Anastomotic Leak / metabolism
  • Aorta, Abdominal / diagnostic imaging*
  • Aorta, Abdominal / metabolism
  • Atherosclerosis / complications*
  • Atherosclerosis / epidemiology
  • Atherosclerosis / metabolism
  • Calcium / metabolism*
  • Colon / surgery*
  • Denmark / epidemiology
  • Female
  • Humans
  • Iliac Artery / diagnostic imaging*
  • Iliac Artery / metabolism
  • Incidence
  • Male
  • Rectum / surgery*
  • Risk Factors
  • Tomography, X-Ray Computed

Substances

  • Calcium