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Int J Colorectal Dis. 2009 Jul;24(7):789-95. doi: 10.1007/s00384-009-0692-4. Epub 2009 Mar 21.

After-hours colorectal surgery: a risk factor for anastomotic leakage.

Author information

  • 1Department of Surgery, ZNA Middelheim, Antwerp, Belgium. nielskomen@hotmail.com

Abstract

PURPOSE:

This study aims to increase knowledge of colorectal anastomotic leakage by performing an incidence study and risk factor analysis with new potential risk factors in a Dutch tertiary referral center.

METHODS:

All patients whom received a primary colorectal anastomosis between 1997 and 2007 were selected by means of operation codes. Patient records were studied for population description and risk factor analysis.

RESULTS:

In total 739 patients were included. Anastomotic leakage (AL) occurred in 64 (8.7%) patients of whom nine (14.1%) died. Median interval between operation and diagnosis was 8 days. The risk for AL was higher as the anastomoses were constructed more distally (p = 0.019). Univariate analysis showed duration of surgery (p = 0.038), BMI (p = 0.001), time of surgery (p = 0.029), prophylactic drainage (p = 0.006) and time under anesthesia (p = 0.012) to be associated to AL. Multivariate analysis showed BMI greater than 30 kg/m(2) (p = 0.006; OR 2.6 CI 1.3-5.2) and "after hours" construction of an anastomosis (p = 0.030; OR 2.2 CI 1.1-4.5) to be independent risk factors.

CONCLUSION:

BMI greater than 30 kg/m(2) and "after hours" construction of an anastomosis were independent risk factors for colorectal anastomotic leakage.

PMID:
19301016
[PubMed - indexed for MEDLINE]
PMCID:
PMC2689358
Free PMC Article
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