Early predictors of anastomotic leaks after colectomy

C. F. Bellows, L. S. Webber, Daniel Albo, S. Awad, D. H. Berger

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Background: An anastomotic leak after colorectal surgery is associated with significant morbidity and decreased survival. Our aim was to identify the early predictors of anastomotic leaks. Methods: The records of patients undergoing restorative resection for colorectal disease from January 2000 to November 2005 were reviewed. Demographics, clinical events, and laboratory parameters were recorded. Results: A total of 311 patients were included. An anastomotic leak was identified in 25 patients (8%). A leak was suspected and diagnosis confirmed at a mean of 10±1 days postoperatively. More respiratory and neurological events occurred in patients with an anastomotic leak (p<0.001). These events occurred early in the postoperative course and were usually the first signs and symptoms of a leak. More patients with a leak had absence of bowel activity by postoperative day 6 compared to patients without a leak (p<0.0001). Elevations of the white blood cell count or temperature were a late finding. Conclusion: The earliest clinical predictors of an anastomotic leak are pulmonary and/or neurological. Awareness of these findings might help in early diagnosis and treatment of an anastomotic leak.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalTechniques in Coloproctology
Volume13
Issue number1
DOIs
StatePublished - Mar 1 2009
Externally publishedYes

Keywords

  • Anastomotic dehiscence
  • Anastomotic leakage
  • Colon resection
  • Colorectal surgery
  • Postoperative complications
  • Rectal resection
  • Risk factors

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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