title: Colic anastomotic leakage risk factors.
abstract: BACKGROUND
  Anastomotic leakage is a dreaded complication of colorectal surgery, as it greatly increases the morbidity, mortality and has been associated with augmented local recurrence and diminished survival. The frequency of this complication is high in emergency colorectal surgery, especially for bowel occlusion, (13% for emergency vs. 4% in elective), due to visceral distension and, therefore, an incongruence in the size of each of the stumps, combined with the lack of mechanical preparation and risk of fecal contamination during operation.
  
  
  METHODS
  We studied the incidence of anastomotic fistula in the surgery clinic of the "Sf. Pantelimon" Emergency Hospital, between 2006 and 2010, on a lot of 251 patients who underwent different types of colic resection. Apart from the anatomic location of the disease, and the level of anastomosis, we included in our database the following criteria: the patient's age and gender, type of colic pathology, surgical technique, emergency or elective surgery, comorbidities.
  
  
  RESULTS
  An ileocolic anastomosis was performed for 84 patients (33,46 %), for 114 patients (45,41%) a colo-colic anastomosis was carried out, 2 patients (0,79%) had ileorectal anastomosis and 51 patients (20,31%) underwent a colorectal anastomosis. From the comparative analysis of risk factors (the emergency interventions, the anastomosis location, the age and gender of the patient), a significantly increased value of the relative risk of anastomotic fistula was registered for the cases with emergency intervention (x 6,61) and for the colorectal anastomosis following the left hemi colectomies (x 2,23).
  
  
  CONCLUSIONS
  In our study, among the clinical and biological factors analyzed, emergency intervention was the most signiﬁcant factor associated with anastomotic leakage. Surgery performed in emergency settings, on debilitated patients without adequate preoperative preparation, has an increased risk for anastomotic dehiscence.
authors.affiliation: Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy,"Sf. Pantelimon" Emergency University Hospital, Bucharest.
authors.forename: M D
authors.initials: MD
authors.lastname: Calin
authors.affiliation: Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy,"Sf. Pantelimon" Emergency University Hospital, Bucharest.
authors.forename: C
authors.initials: C
authors.lastname: Bălălău
authors.affiliation: Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy,"Sf. Pantelimon" Emergency University Hospital, Bucharest.
authors.forename: F
authors.initials: F
authors.lastname: Popa
authors.affiliation: Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy, Coltea University Hospital, Bucharest.
authors.forename: S
authors.initials: S
authors.lastname: Voiculescu
authors.affiliation: Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy, Coltea University Hospital, Bucharest.
authors.forename: R V
authors.initials: RV
authors.lastname: Scăunașu
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology*; D003106:Colon / Q000601:surgery; D003107:Colorectal Surgery / Q000009:adverse effects*; D006801:Humans; D012007:Rectum / Q000601:surgery; D012307:Risk Factors