Anastomotic dehiscence after resection and primary anastomosis in left-sided colonic emergencies.
OBJECTIVE
There is no consensus about the risk factors for anastomotic failure after elective or emergency colorectal surgery. The purpose of this study was to analyze the factors that may contribute in anastomotic dehiscence.


METHODS
A total of 208 patients who underwent left colonic resection and primary anastomosis for distal colonic emergencies were studied. Preoperative and operative variables analyzed for each patient were gender, age, American Society of Anesthesiologists score, comorbidities, indication for surgery, etiology of the disease, presence and grade of peritonitis, preoperative creatinine, hematocrit, hemoglobin, and leukocyte count, need for preoperative and operative transfusion. The end point was the clinical evident incidence of anastomotic leak. Bivariate comparisons of those patients with or without anastomotic leak were unpaired, and all tests of significance were two-tailed. A multivariate analysis, in which presentation of anastomotic leak was the dependent outcome variable, was performed by forward stepwise logistic regression model.


RESULTS
One hundred five patients (50.4 percent) had one or more complications. Anastomotic leak was diagnosed in 12 patients (5.7 percent). Seventeen patients (8.2 percent) needed a reoperation for complication. The overall mortality was 6.2 percent (13 patients). Obesity was significant as a predictor of anastomotic leak.


CONCLUSIONS
Obesity is a factor predicting anastomotic leak risk after resection and primary anastomosis for left-sided colonic emergencies.
Biondo
Sebastiano
S
Department of Surgery, Hospital Universitario de Bellvitge, University of Barcelona, Barcelona, Spain. sbiondo@csub.scs.es
Parés
David
D
Kreisler
Esther
E
Ragué
Juan Martí
JM
Fraccalvieri
Domenico
D
Ruiz
Amador Garcia
AG
Jaurrieta
Eduardo
E
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000601:surgery*; D015897:Comorbidity; D004638:Emergency Treatment / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010538:Peritonitis / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000473:pathology