Smoking as dominant risk factor for anastomotic leak after left colon resection

Rebeccah B. Baucom, Benjamin K. Poulose, Alan J. Herline, Roberta L. Muldoon, Molly M. Cone, Timothy M. Geiger

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background Some risk factors for anastomotic leak have been identified, but the effect of smoking is unknown. Methods This study aimed to evaluate the effect of smoking on clinical leak after left-sided anastomoses. Adult patients who underwent elective left colectomy between January 1, 2008 and December 31, 2012 were included. Those with stomas and inflammatory bowel diseases were excluded. Primary outcome was anastomotic leak requiring percutaneous drainage or operative intervention within 30 days. Results There were 246 patients included; 56% were female. Most had a diagnosis of diverticular disease (53%) or cancer (37%). Anastomotic leak rate was 6.5% (n = 16). The rate in smokers was 17% versus 5% in nonsmokers (P =.01). Smokers had over 4 times greater chance of leak (odds ratio 4.2, 95% confidence interval 1.3 to 13.5, P =.02). Conclusion Smoking is a risk factor for leak after left colectomy. Consideration should be given to delaying elective left colectomy until smoking cessation is achieved.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalAmerican Journal of Surgery
Issue number1
StatePublished - Jan 1 2015
Externally publishedYes


  • Anastomotic leak
  • Colectomy
  • Left colectomy
  • Risk factors
  • Smoking

ASJC Scopus subject areas

  • Surgery

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