title: Anastomotic dehiscence after resection and primary anastomosis in left-sided colonic emergencies.
abstract: 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.
authors.affiliation: Department of Surgery, Hospital Universitario de Bellvitge, University of Barcelona, Barcelona, Spain. sbiondo@csub.scs.es
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Biondo
authors.forename: David
authors.initials: D
authors.lastname: Parés
authors.forename: Esther
authors.initials: E
authors.lastname: Kreisler
authors.forename: Juan Martí
authors.initials: JM
authors.lastname: Ragué
authors.forename: Domenico
authors.initials: D
authors.lastname: Fraccalvieri
authors.forename: Amador Garcia
authors.initials: AG
authors.lastname: Ruiz
authors.forename: Eduardo
authors.initials: E
authors.lastname: Jaurrieta
mesh_terms: 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