[Risk factors for anastomotic leakage after colorectal surgery].
BACKGROUND
Despite improved surgical techniques, anastomotic leakage is still a serious complication in colorectal surgery, resulting in increased morbidity and mortality. This study was initiated to investigate those clinical risk factors which may influence the onset of anastomotic wound-healing complications.


METHODS
The postoperative courses were assessed in 400 consecutive patients who underwent colonic or rectal resection. Possible clinical risk factors were investigated by unvariate and multivariate analysis.


RESULTS
23 patients developed an anastomotic leakage (5.8 %). 10 patients could be treated conservatively, 13 had a second operation. In the multivariate analysis significant risk factors were perioperative radiotherapy (OR = 3.76 [95 % CI 1.03-13.7]), blood transfusion (OR = 2.98 [95 % CI 1.18-7.54]), alcohol consumption (OR = 2.94 [95 % CI 1.06-8.17]), and steroid medication (OR = 3.91 [95 % CI 1.17-13.07]).


CONCLUSIONS
The clinically most important risk factors for leakage were radiotherapy and blood transfusion. Further analyses with a focus on the extracellular matrix, including other clinical factors may be valuable in identifying targets for improvement.
Stumpf
M
M
Chirurgische Universitätsklinik, RWTH Aachen, Aachen. mstumpf@ukaachen.de
Junge
K
K
Wendlandt
M
M
Krones
C
C
Ulmer
F
F
Klinge
U
U
Schumpelick
V
V
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D001803:Blood Transfusion; D003082:Colectomy; D003106:Colon / Q000528:radiation effects; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000528:radiation effects / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D055815:Young Adult
D000305:Adrenal Cortex Hormones