Calcium score: a new risk factor for colorectal anastomotic leakage.
BACKGROUND
Anastomotic leakage (AL) is the most feared complication of colorectal surgery. Atherosclerosis is suggested to have a detrimental effect on anastomotic healing. This study aimed to analyze the calcium score, a measure for atherosclerosis, as a risk factor for AL.


METHODS
The calcium scores of colorectal patients operated on in 2 Dutch university medical centers were determined using a computed tomography scan and calcium scoring software. The aorta, common iliac arteries, internal and external iliac arteries were studied. Additionally, patient- and operation-related factors were scored.


RESULTS
A total of 122 patients were included. In patients with AL, calcium scores were significantly higher in the left common iliac artery (561.4 vs 156.0, P = .028), right common iliac artery (542.0 vs 144.4, P = .041), both common iliac arteries together (1,103.3 vs 301.9, P = .046), and the left internal iliac artery (716.3 vs 35.3, P = .044).


CONCLUSIONS
Patients with higher calcium scores in the iliacal arteries have an increased leakage risk.
Komen
Niels
N
Department of Surgery, University Medical Center Rotterdam, Erasmus MC, Rotterdam, Kingdom of the Netherlands. nielskomen@hotmail.com
Klitsie
Pieter
P
Dijk
Jan Willem
JW
Slieker
Juliette
J
Hermans
John
J
Havenga
Klaas
K
Oudkerk
Matthijs
M
Weyler
Joost
J
Kleinrensink
Gert-Jan
GJ
Lange
Johan F
JF
D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000378:metabolism; D050197:Atherosclerosis / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D002118:Calcium / Q000378:metabolism*; D003106:Colon / Q000601:surgery*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000378:metabolism; D015994:Incidence; D008297:Male; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D002118:Calcium