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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 8/2007

01-08-2007 | Original Article

Risk factors for clinical anastomotic leakage and postoperative mortality in elective surgery for rectal cancer

Authors: Martin Kruschewski, Hayo Rieger, Uwe Pohlen, Hubert G. Hotz, Heinz J. Buhr

Published in: International Journal of Colorectal Disease | Issue 8/2007

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Abstract

Background and aims

Clinical anastomotic leakage remains a major problem after anterior or low anterior resection for rectal cancer. The aim of this study was to assess the association between risk factors and anastomotic leakage and postoperative mortality.

Materials and methods

Two hundred seventy-six elective anterior or low anterior resections with anastomosis were performed and documented on-line from January 1995 to December 2004. Univariate and multivariate analyses with Bonferroni adjustment were carried out to identify relevant risk factors.

Results

The rate of anastomotic leakage was 14.9% (41 of 276 patients) with a mortality of 12.2% (5 of 41 patients). Overall mortality was 2.5% (7 of 276 patients). Multiple regression analysis showed that smokers had an increased risk of anastomotic leakage [odds ratio (OR), 6.42; 95% confidence interval (CI), 2.68–15.36] as well as patients with coronary heart disease (OR, 7.79; 95% CI, 2.52–24.08). Smokers (OR, 13.20; 95% CI, 2.48–7.24) and patients with coronary heart disease (OR, 23.46; 95% CI, 4.33–27.04) also had an increased risk of postoperative mortality in the univariate analysis as well as patients with anastomotic leakage (OR, 16.25; 95% CI, 3.04–16.92).

Conclusions

Smoking and coronary heart disease are important risk factors for anastomotic leakage and postoperative mortality after elective resection for rectal cancer.
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Metadata
Title
Risk factors for clinical anastomotic leakage and postoperative mortality in elective surgery for rectal cancer
Authors
Martin Kruschewski
Hayo Rieger
Uwe Pohlen
Hubert G. Hotz
Heinz J. Buhr
Publication date
01-08-2007
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 8/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-006-0260-0

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