Boccola et al identified risk factors for anastomotic leaks after colorectal cancer. The presence of an anastomotic leak is associated with worse overall survival. The authors are from James Cook University, Royal Brisbane Hospital and University of Queensland in Australia.
Patient selection: colorectal anastomosis
Types of anastomotic leaks:
(1) radiological (asymptomatic; found on gastrograffin enema performed prior to stoma closure)
(2) local
(3) generalized
Risk factors for anastomotic leak based on logistic regression analysis:
(1) simultaneously performed major gynecological surgery (odds ratio 3.1)
(2) any postoperative blood transfusion (odds ratio 3.1)
(3) distal rectal cancer (less than 8 cm; odds ratio 4.8)
(4) TNM stage II to IV (odds ratio 2.3)
Additional risk factors for anastomotic leak:
(1) simultaneously performed total cystectomy
(2) anterior resection
(3) use of an intraluminal stapling device
(4) abdominal drain via laparoscopic port
