Predicting Anastomotic Disruption After Emergent Intestinal Surgery

Abstract

Introduction Suture line disruption is an important cause of post-operative morbidity and mortality in patients who have undergone bowel surgery. Our aim was to study peri-operative factors causing anastomotic disruption in emergency surgeries and also morbidity and mortality associated with it. AfterMethodology obtaining ethical clearance from Institutional Ethical Committee, the present prospective study was conducted on 68 patients during the study period of two years (September 2017- August 2019) in a tertiary care hospital A total of 68 emergencyResults bowel anastomosis meeting the inclusion criteria were performed with 50 (73.5%) males patients. Anastomotic leak was present in 10 patients ((14.7%). The mean age of subjects in our series sustaining a leak was 62.60±6.95 years. Intra-operative hypotension, colo-colic anastomosis, post-operative vasopressor support, pre-operative hypoalbuminemia, hyponatremia and Intra-operative uid infused were signicantly associated with anastomosis leak. In our study majority of patients with anastomotic leak were of older age group. In anstomotic leak group chest infection, wound infection, septicemia and impaired renal function was present in 8, 10, 3, and 4 patients respectively. Among the 10 cases of anastomotic leak, four patients were managed conservatively and remaining six develop features of peritonitis, who were immediately taken for re-exploration. There were three deaths in the study, all of them were in leak group. Patients who have predisposing factors forConclusion leakage should ideally be considered for a temporary defunctioning stoma to tide the crisis over.