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Article: Leakage after resection and intraperitoneal anastomosis for colorectal malignancy: Analysis of risk factors

TitleLeakage after resection and intraperitoneal anastomosis for colorectal malignancy: Analysis of risk factors
Authors
KeywordsAnastomotic leakage
Intraperitoneal large-bowel anastomosis
Risk factors
Issue Date2006
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/
Citation
Diseases Of The Colon And Rectum, 2006, v. 49 n. 11, p. 1719-1725 How to Cite?
AbstractPURPOSE: The study was designed to identify the risk factors associated with anastomotic leakage after an intraperitoneal large-bowel anastomosis in patients with colorectal malignancy. METHODS: The prospectively collected data of patients who underwent colorectal resection for malignancy with primary anastomosis above the pelvic peritoneal reflection for malignancy between 1996 and 2004 were reviewed. Thirty-five variables were evaluated using univariate and multivariate analysis. RESULTS: A total of 1,417 patients were studied and anastomotic leakage occurred in 25 patients (1.8 percent). Twenty-two patients (88 percent) required reoperation for anastomotic leakage. The hospital stay (28 vs. 10 days, P < 0.001) and mortality rate (32 vs. 4 percent, P < 0.001) of patients with anastomotic leakage were significantly increased compared with those without leakage. Multivariate analysis showed that American Society of Anesthesiologists Grade 3 to 5 (P = 0.04; odds ratio, 5.6; 95 percent confidence interval, 1.6-15.3) and emergency operation (P = 0.03; odds ratio, 4.6; 95 percent confidence interval, 1.9-9.8) were independent factors associated with anastomotic leakage. The risk of anastomotic leakage was 8.1 percent (odds ratio, 10.5; 95 percent confidence interval, 2.7-26.8) if both factors were present. CONCLUSIONS: Intraperitoneal anastomosis after large-bowel resection is associated with a low leakage rate. Emergency surgery and a high American Society of Anesthesiologists grade are independent factors associated with an increased incidence of leakage. A temporary diverting stoma to protect the primary anastomosis or even avoidance of anastomosis could be considered for patients with the two risk factors present. © 2006 The American Society of Colon and Rectal Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/84510
ISSN
2015 Impact Factor: 3.739
2015 SCImago Journal Rankings: 2.077
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChoi, HKen_HK
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorHo, JWCen_HK
dc.date.accessioned2010-09-06T08:53:48Z-
dc.date.available2010-09-06T08:53:48Z-
dc.date.issued2006en_HK
dc.identifier.citationDiseases Of The Colon And Rectum, 2006, v. 49 n. 11, p. 1719-1725en_HK
dc.identifier.issn0012-3706en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84510-
dc.description.abstractPURPOSE: The study was designed to identify the risk factors associated with anastomotic leakage after an intraperitoneal large-bowel anastomosis in patients with colorectal malignancy. METHODS: The prospectively collected data of patients who underwent colorectal resection for malignancy with primary anastomosis above the pelvic peritoneal reflection for malignancy between 1996 and 2004 were reviewed. Thirty-five variables were evaluated using univariate and multivariate analysis. RESULTS: A total of 1,417 patients were studied and anastomotic leakage occurred in 25 patients (1.8 percent). Twenty-two patients (88 percent) required reoperation for anastomotic leakage. The hospital stay (28 vs. 10 days, P < 0.001) and mortality rate (32 vs. 4 percent, P < 0.001) of patients with anastomotic leakage were significantly increased compared with those without leakage. Multivariate analysis showed that American Society of Anesthesiologists Grade 3 to 5 (P = 0.04; odds ratio, 5.6; 95 percent confidence interval, 1.6-15.3) and emergency operation (P = 0.03; odds ratio, 4.6; 95 percent confidence interval, 1.9-9.8) were independent factors associated with anastomotic leakage. The risk of anastomotic leakage was 8.1 percent (odds ratio, 10.5; 95 percent confidence interval, 2.7-26.8) if both factors were present. CONCLUSIONS: Intraperitoneal anastomosis after large-bowel resection is associated with a low leakage rate. Emergency surgery and a high American Society of Anesthesiologists grade are independent factors associated with an increased incidence of leakage. A temporary diverting stoma to protect the primary anastomosis or even avoidance of anastomosis could be considered for patients with the two risk factors present. © 2006 The American Society of Colon and Rectal Surgeons.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/en_HK
dc.relation.ispartofDiseases of the Colon and Rectumen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectAnastomotic leakageen_HK
dc.subjectIntraperitoneal large-bowel anastomosisen_HK
dc.subjectRisk factorsen_HK
dc.subject.meshAnastomosis, Surgical - adverse effects - methods - mortality-
dc.subject.meshColorectal Neoplasms - pathology - surgery-
dc.subject.meshLength of Stay - statistics and numerical data-
dc.subject.meshMultivariate Analysis-
dc.subject.meshReoperation - statistics and numerical data-
dc.titleLeakage after resection and intraperitoneal anastomosis for colorectal malignancy: Analysis of risk factorsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3706&volume=49&issue=11&spage=1719&epage=1725&date=2006&atitle=Leakage+after+resection+and+intraperitoneal+anastomosis+for+colorectal+malignancy:+analysis+of+risk+factorsen_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10350-006-0703-2en_HK
dc.identifier.pmid17051321-
dc.identifier.scopuseid_2-s2.0-33751299008en_HK
dc.identifier.hkuros135980en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33751299008&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume49en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1719en_HK
dc.identifier.epage1725en_HK
dc.identifier.isiWOS:000242029300007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChoi, HK=7404339913en_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridHo, JWC=7402649983en_HK

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