title: Colorectal anastomotic leakage at the university hospital of the west indies: an analysis of risk factors.
abstract: BACKGROUND
  Anastomotic leakage remains a concern in general surgical practice. The significance lies in the resultant abdominal sepsis, related morbidity and mortality, risk of anastomotic loss, permanent stoma creation and the effect on local recurrence and overall patient survival in colorectal cancer cases.
  
  
  OBJECTIVE
  This study serves to determine the leak rates and the mortality thereof related to colonic and rectal anastomoses at the University Hospital of the West Indies (UHWI) in Kingston, Jamaica. Independent factors contributing to anastomotic leaks in these patients will also be assessed and correlations determined.
  
  
  METHODS
  A review of the medical records of one hundred and thirty-three cases of colonic and rectal anastomoses identified retrospectively over a three-year period provided relevant information for analysis.
  
  
  RESULTS
  Anastomotic leaks were identified in twelve patients, providing a leak rate of 9.0%. No 30-day mortality related to anastomotic leakage was noted. Based on a multivariate analysis, male gender was identified as the sole independent factor related to anastomotic leakage.
  
  
  CONCLUSIONS
  Colorectal anastomotic leak rates at UHWI fell at the upper limit of leak rates typically quoted in the literature. No modifiable risk factor appeared to contribute to this leak rate. Early identification and intervention is critical in limiting mortality associated with colorectal anastomotic leakage.
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies. paeleake@yahoo.com.
authors.forename: P A
authors.initials: PA
authors.lastname: Leake
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: J M
authors.initials: JM
authors.lastname: Plummer
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: A
authors.initials: A
authors.lastname: Rhoden
authors.affiliation: Health Research Resource Unit, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: M Ac
authors.initials: MA
authors.lastname: Frankson
authors.affiliation: Health Research Resource Unit, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: G
authors.initials: G
authors.lastname: Gordon-Strachan
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: L P
authors.initials: LP
authors.lastname: Powell
authors.affiliation: Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston 7, Jamaica, West Indies.
authors.forename: P O
authors.initials: PO
authors.lastname: Roberts