Risk Factors for Leakage of Colonic Anastomosis

 

Factors associated with leakage of a colonic anastomosis:

(1) preoperative anemia

(2) intraoperative hypotension

(3) massive hemorrhage (associated with intraoperative hypotension)

(4) peri-operative transfusions (especially if 4 or more units transfused)

(5) emergency surgery without adequate bowel preparation, especially in the left colon (associated with infection)

(6) presence of infection (before or after surgery)

(7) bowel within field for radiation therapy

(8) surgical margins positive for malignancy

(9) prolonged duration of surgery (> 5 hours)

(10) poor blood supply

(11) increased age (noticeable if > 60 and more so if > 81 years of age)

(12) extraperitoneal rectal anastomosis

 

Interestingly, steroid therapy, malnutrition and comorbid diseases were not associated with increased risk of leakage.