Vayalapalli Manmadha Rao, Prasadula Ashok, Mantra Sanjay , Surisetty Srinivas Rao
BACKGROUND Anastomotic dehiscence is the most severe surgical complication after large bowel resection. This study was designed to assess the incidence, to observe the consequences, and to identify the risk factors associated with anastomotic leakage after colorectal surgery. MATERIALS AND METHODS All patients who were admitted for colorectal carcinoma or large bowel obstruction and underwent colorectal resection between January 2016 to August 2017 in a single institution were prospectively studied. RESULTS Over 20 months period, 150 anastomoses over colorectal surgeries were performed. 80 patients underwent surgeries for colorectal carcinoma. 70 patients for sigmoid volvulus obstruction. Emergency procedures were performed in 70 Patients. Elective procedures were about 80 patients. Surgeries performed are 70 sigmoidectomies, 50 right hemicolectomies, 77 left hemicolectomies, 23 low anterior resections. The overall anastomotic leak rate was 4%. The mortality rate associated with anastomotic leak was 12.9%. In univariate analysis, the following parameters were associated with an increased risk for anastomotic dehiscence: 1) ASA score>= (p=0.004). 2) Prolonged operation time (>3hrs) (p=0.02). 3) Rectal location of disease (p=0.05). 4) BMI>25 (p=0.04). CONCLUSION Anastomosis location within the rectum is over 7 times more likely to leak than an ileocolic anastomosis (right colon) and almost 4 times more likely to leak than a colocolic anastomosis (left colon). Other risk factors for leak is prolonged operating time.
