Coordinators : dr. Lucian Mocan , dr. Cornel Iancu

Assessment of risk factors for anastomotic leak occurrence after resection of colorectal cancer

Author: Teodora Irina Adam

Coauthors: Alexandru Achim, Dragoș Aconstantinesei , Vlad Bura, Patricia Furda

• Radical tumor resection – curative procedure in colorectal cancer

• Anastomotic leaks (AL) are widely considered the Achilles heel of colorectal surgery

• UK SISG: a “leak of luminal contents from a surgical join between two hollow viscera”

Background

Bruce J, Krukowski ZH, Al-Khairy G, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.

• Incidence of AL varies between institutions depending on the definition chosen

• Certain factors are known to increase the likelihood of an AL

Background

Bruce J, Krukowski ZH, Al-Khairy G, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.

• Identify risk factors for AL

• Assess the correlation between the observed risk factors and AL

Objectives

• Retrospective study

• 310 patients

(01.01.2013 – 31.03.2014)

• Data collection: Standard form

Methods

Methods

preOP intraOP postOP

Anemia Suture method Timing of oral nutrition and mobilization

Hypoproteinemia Anastomosis technique

Topography of neoplastic lesions

Intraoperative events

- Observed parameters

- Data analysis

Results

PreOP parameters

Results

Anemia

Hypoproteinemia

Topography of neoplastic lesion

Anastomotic Leak

Chi- Square

Results

Chi-Squared

H10: “There is no significance between anemia and AL occurence”

H20: “There is no significance between hypoproteinemia and AL occurence”

H30: “There is no significance between topography of neoplastic lesions and AL occurence”

Results

Chi-Squared

2-1 = 1 degree of freedom

Results

AnemiaHypoproteinemia

Anastomotic Leak

Topography

Anastomotic Leak

X2> 3,84 X2 (-3,84;3,84)

Results

Chi-Squared

Results

Chi-Squared

“There is significance between anemia and AL”

“There is significance between hypoproteinemia and AL”

Results

IntraOP

Results

Chi-Squared

Results

Suture method

Anastomosis technique

Anastomotic Leak

Chi- Square

Suture method

Anastomosis technique

Anastomotic Leak

X2 (-3,84;3,84)

Results

Chi-Squared

Results

PostOP

24 - 48 h

2,58 %

Conclusions

Anemia Hypoproteinemia

Risk factors for AL

Delayed postoperative oral nutrition and patient

mobilization

Discussions

• More patients included in the study• Single surgeon experience ?• Prospective study

Further investigation

Thank you !