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BMC Surgery
Published in: BMC Surgery 1/2021

Open Access 01-12-2021 | Enterostomy | Research article

The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study

Authors: Selmy Awad, Ahmed Ibrahim Abd El-Rahman, Ashraf Abbas, Waleed Althobaiti, Shaker Alfaran, Saleh Alghamdi, Saleh Alharthi, Khaled Alsubaie, Soliman Ghedan, Rayan Alharthi, Majed Asiri, Azzah Alzahrani, Nawal Alotaibi, Ashraf Shoma, Mohamed Samir Abou Sheishaa

Published in: BMC Surgery | Issue 1/2021

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Abstract

Background

Anastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of detected leaks. The purpose of the research was to assess the perioperative risk factors for AL.

Methods

This study was achieved at MUH and MIH/Egypt within the period between January 2016 and January 2019 for the candidates who underwent bowel anastomosis for small intestinal (except duodenal one) and colorectal pathology. The collected data were analyzed using SPSS of V-26.

Results

This study included 315 cases, among them, 27 cases (8.57%) developed AL. The percentage of covering stoma was significantly higher in the non-leakage group vs leakage one (24.3% vs 11.1% respectively). lower albumin, operative timing, perforation, and covering stoma were shown as significant risk factors for leakage, but with multivariate analysis for these factors, the emergency operation, and serum albumin level was the only independent risk factors that revealed the significance consequently (p = 0.043, p = 0.015). The analysis of different predictors of AL on the third day showed that the cut-off point in RR was 29 with 83% sensitivity and 92% specificity in prediction of leakage, the cut-off point in RR was 118 with 74% sensitivity and 87% specificity in prediction of leakage and the cut-off point in CRP was 184.7 with 82% sensitivity and 88% specificity in prediction of AL and all had statistically significant value.

Conclusions

The preoperative serum albumin level and the emergency operations are independent risk factors for anastomotic leakage. Moreover, leakage should be highly suspected in cases with rising respiratory rate, heart rate, and CRP levels.
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Metadata
Title
The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study
Authors
Selmy Awad
Ahmed Ibrahim Abd El-Rahman
Ashraf Abbas
Waleed Althobaiti
Shaker Alfaran
Saleh Alghamdi
Saleh Alharthi
Khaled Alsubaie
Soliman Ghedan
Rayan Alharthi
Majed Asiri
Azzah Alzahrani
Nawal Alotaibi
Ashraf Shoma
Mohamed Samir Abou Sheishaa
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2021
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-020-01044-8

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