[Anastomotic leakage following bowel resections for colon cancer: multivariate analysis of risk factors].
BACKGROUND
The aim of this study was to evaluate the incidence and risk factors associated with anastomotic leakage after colon cancer surgery using data compiled in the nationwide German qualitative multi-center study "Colon/Rectum Cancer" (WGCRC).


METHODS
From 01/01/2000 to 12/31/2004 data recorded from patients with anastomotic leakages were evaluated to determine independent predictors of leakage using logistic regression analysis.


RESULTS
A total of 28,271 patients underwent colon resection with anastomoses and anastomotic leaks occurred in 3.0% (n=844). Multivariate analysis identified long duration of surgery, a high ASA score, male gender, obstruction, left-sided tumor, cardiovascular hepatic comorbidity, single-layer hand suture, anastomoses using the biofragmentable Valtrac ring, intraoperative complications and BMI>30 kg/m(2) as risk factors for postoperative occurrence of anastomotic leakage.


CONCLUSIONS
Even though the rate of anastomotic leaks in patients with anastomoses after resection for colon cancer is low, it remains a significant complication, associated with significant morbidity and mortality. The knowledge of risk factors should be considered in perioperative decision-making regarding anastomotic technique and indications for Hartmann's procedure.
Kube
R
R
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Universitätsklinikum A.ö.R., Leipziger Strasse 44, Magdeburg, Germany. rainer.kube@med.ovgu.de
Mroczkowski
P
P
Steinert
R
R
Sahm
M
M
Schmidt
U
U
Gastinger
I
I
Lippert
H
H
D000368:Aged; D001466:Barium Sulfate; D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D012086:Reoperation / Q000401:mortality / Q000706:statistics & numerical data; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000601:surgery*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013536:Suture Techniques / Q000295:instrumentation
C433875:Valtrac; D001466:Barium Sulfate; D011100:Polyglycolic Acid