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Minerva Chir. 2003 Apr;58(2):167-74.

[Anastomotic leakage after traditional surgery of the colon and rectum].

[Article in Italian]

Author information

1
Divisione di Chirurgia Generale, ASL 1 Imperiese, Presidio Ospedaliero di Imperia, Italy. abete.im@libero.it

Abstract

BACKGROUND:

Anastomotic leakage after traditional surgery of the colon and rectum represents one of the more frightening complications for its high incidence (5-10%) leading to a mortality of 10-33%. The aim of the study is to analyze the main etiopathogenetic factors of this complication in the literature and, retrospectively, in personal experience.

METHODS:

At the General Surgery Department of the Hospital of Imperia, between September 1997 and August 2001, 278 laparotomic procedures with large bowel anastomosis were completed; 37 patients (13.3%) were treated in emergency. There were 153 males (55%) and 125 females (45%), the average age being 70.5 years (range 41-94). The mean hospital stay was 12 days (range 7-45).

RESULTS:

The incidence of perioperative mortality was 1.1% (3 cases). Anastomotic leakage occurred in 4 patients (1.4%); one of these died. Analysis of the presented series confirms that factors contributing to leakage of colonic anastomoses are: distal rectum anastomoses, rectal cancer, experience of the surgeon and preoperative radiotherapy. Anastomotic leakage didn't occur in emergency, probably for a prudent attitude that considers multiple-stages surgical procedures in high-risk patients; besides a radical subtotal or total colectomy was performed in the treatment of obstructive cancer of the left colon and rectum.

CONCLUSIONS:

The incidence of anastomotic leakage in colo-rectal surgery was lower when anastomoses were performed in ideal circumstances; it is necessary to know the main risk factors to reduce this complication.

PMID:
12738926
[Indexed for MEDLINE]
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