Colorectal anastomotic leakage can be predicted by abdominal aortic calcification on preoperative CT scans: A pilot study.
BACKGROUND
There have been no solid data regarding whether patients with aortic calcification (AC) who have undergone colorectal surgery are at increased risk for anastomotic leakage. Our study aim to investigate the impact of AC on anastomotic leakage (AL) and postoperative morbidity after colorectal resection.


METHODS
This was a cohort study of 60 patients who were prospectively registered in a database. We evaluated the relationship between an aortic calcification score (ACS), measured on preoperative computed tomography (CT) imaging, and surgical complications in patients undergoing colorectal surgery.


RESULTS
ACS was strongly correlated with mortality rate. All three of the deceased patients were in the ACS-2 group (5%; P=0.021). The rate of AL was positively correlated with ACS; no leakage was found cases of ACS-0, with a rate of 18% in cases of ACS-1 and 44% in cases of ACS-2 (P=0.022). The consequences of AL were more serious according to the grade of ACS.


CONCLUSIONS
This study suggested that aortic calcification score is correlated with surgical outcomes, particularly anastomosis leakage, after colorectal surgery. These findings could provide useful tools for adapting surgical strategies by delaying colorectal anastomosis in high-risk patients.
Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: clarisse.eveno@gmail.com.
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Eveno
Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
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Latrasse
Department of intensive care and anaesthesiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
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Gayat
Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
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Lo Dico
Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Department of abdominal and interventional imaging, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; McGill university health center, department of radiology, McGill university health center, 1650, Cedar avenue, C5 118 Montreal, QC, Canada.
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Dohan
Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
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Pocard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D001011:Aorta / Q000000981:diagnostic imaging*; D003082:Colectomy / Q000401:mortality; D015179:Colorectal Neoplasms / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000150:complications* / Q000000981:diagnostic imaging
Anastomotic leakage; Aortic calcification; Colorectal surgery; Mortality