title: Is aortoiliac calcification linked to colorectal anastomotic leakage? A case-control study.
abstract: BACKGROUND
  Anastomotic leakage in bowel surgery remains a devastating complication. Various risk factors have been uncovered, however, high anastomotic leakage rates are still being reported. This study describes the use of calcification markers of the central abdominal arteries as a prognostic factor for colorectal anastomotic leakage.
  
  
  METHODS
  This case-control study includes clinical data from three different hospitals. Calcium volume and calcium score of the aortoiliac tract were determined by CT-scan analysis. Cases were all patients with anastomotic leakage after a left-sided anastomosis (n = 30). Three controls were randomly matched for each case. Only patients with a contrast-enhanced pre-operative CT-scan were included.
  
  
  RESULTS
  The measurements of the calcium score and calcium volume of the different trajectories showed that there was one significant difference with regard to the right external iliac artery. Multiple regression analysis showed a significant different negative odds ratio of the presence of calcium in the right external iliac artery.
  
  
  CONCLUSIONS
  This study demonstrates that calcium volume and calcium score of the aortoiliac trajectory does not correlate with the risk of colorectal anastomotic leakage after a left-sided anastomosis.
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: g.boersema@erasmusmc.nl.
authors.forename: G S A
authors.initials: GS
authors.lastname: Boersema
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: K A
authors.initials: KA
authors.lastname: Vakalopoulos
authors.affiliation: Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors.forename: M C J M
authors.initials: MC
authors.lastname: Kock
authors.affiliation: Department of Radiology, Medical University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: P M A
authors.initials: PM
authors.lastname: van Ooijen
authors.affiliation: Department of Surgery, Medical University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Havenga
authors.affiliation: Department of Neuroscience-Anatomy, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Kleinrensink
authors.affiliation: Department of Neuroscience-Anatomy, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Jeekel
authors.affiliation: Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Lange
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D007422:Intestines / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011859:Radiography; D012307:Risk Factors; D061205:Vascular Calcification / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Anastomotic leakage; Calcium score; Calcium volume; Colorectal surgery; Prognostic factor