Risk Factors for Anastomotic Leakage After Colectomy

Abstract

Fecal contamination and increased blood loss during colectomy should raise suspicion for potential postoperative anastomotic leakage.

Duodenal stump fistula after gastric surgery for malignancies: a retrospective analysis of risk factors in a single centre experience

“…Increased blood losses during surgery are referred to be a risk factor for complications in Duodenal stump fistula risk factors 741 general after abdominal surgery, not only for DSF [35]. In particular, for what concern gastric surgery, no studies were found in literature describing direct correlation between intra-operative blood losses and post-operative complications.…”

Ghrelin and gastrointestinal wound healing. A new perspective for colorectal surgery

“…Nutritional status is another important factor. Many studies have demonstrated the correlation of low serum protein levels and AL showing a decrease of anastomotic complications with preoperative nutritional improvement 6,8,10 . Smoking and alcohol abuse are conditions that have also been associated with AL because they cause microvascular disease and ischemia and consequent anastomotic healing failure 16 .…”

“…Diverting stoma also is a controversial condition because it does not act directly in the healing process; it only prevents major septic complications by diverting fecal stream and sometimes delays the fistula diagnosis in the postoperative period. Nowadays this procedure should be considered in patients who underwent low rectal anastomosis (below 6cm from anal verge), neoadjuvant radiotherapy and critically ill patients 10,11,16 . Finally, mechanical bowel preparation remains a controversial perioperative condition in the processes of anastomotic dehiscence.…”

“…Anastomotic leakage is the most feared and potentially fatal complication after colorectal surgery because usually results in high morbidity and mortality, increase length of stay, medical costs and is associated with poorer long-term oncological results [1][2][3][4][5] . The prevalence of anastomotic leakage has been reported to range from 1 to 26% 1,2,[6][7][8][9][10][11] . Multiple factors are involved in healing process of colorectal anastomosis, including technical-related factors and patients-specific characteristics.…”

The comparison of laparoscopic and conventional surgery for colorectal cancers: Evaluation of the initial experience

“…[15] Other anastomotic leakage risk factors such as increased blood loss and fecal contamination were not present in the patient. [16] The postoperative course of the patient was uneventful, except for controlled drainage. The drain was observed and removed on the postoperative 25 th day.…”