Zentralblatt fur Chirurgie · 2009
[Risk factors for anastomotic leakage after colorectal surgery].
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Stumpf M, Junge K, Wendlandt M, Krones C, Ulmer F, Klinge U, Schumpelick V
Аннотация
BACKGROUND: Despite improved surgical techniques, anastomotic leakage is still a serious complication in colorectal surgery, resulting in increased morbidity and mortality. This study was initiated to investigate those clinical risk factors which may influence the onset of anastomotic wound-healing complications.
METHODS: The postoperative courses were assessed in 400 consecutive patients who underwent colonic or rectal resection. Possible clinical risk factors were investigated by unvariate and multivariate analysis.
RESULTS: 23 patients developed an anastomotic leakage (5.8 %). 10 patients could be treated conservatively, 13 had a second operation. In the multivariate analysis significant risk factors were perioperative radiotherapy (OR = 3.76 [95 % CI 1.03-13.7]), blood transfusion (OR = 2.98 [95 % CI 1.18-7.54]), alcohol consumption (OR = 2.94 [95 % CI 1.06-8.17]), and steroid medication (OR = 3.91 [95 % CI 1.17-13.07]).
CONCLUSION: The clinically most important risk factors for leakage were radiotherapy and blood transfusion. Further analyses with a focus on the extracellular matrix, including other clinical factors may be valuable in identifying targets for improvement.
METHODS: The postoperative courses were assessed in 400 consecutive patients who underwent colonic or rectal resection. Possible clinical risk factors were investigated by unvariate and multivariate analysis.
RESULTS: 23 patients developed an anastomotic leakage (5.8 %). 10 patients could be treated conservatively, 13 had a second operation. In the multivariate analysis significant risk factors were perioperative radiotherapy (OR = 3.76 [95 % CI 1.03-13.7]), blood transfusion (OR = 2.98 [95 % CI 1.18-7.54]), alcohol consumption (OR = 2.94 [95 % CI 1.06-8.17]), and steroid medication (OR = 3.91 [95 % CI 1.17-13.07]).
CONCLUSION: The clinically most important risk factors for leakage were radiotherapy and blood transfusion. Further analyses with a focus on the extracellular matrix, including other clinical factors may be valuable in identifying targets for improvement.
Предметные рубрики MeSH
Adrenal Cortex HormonesAdultAgedAlcohol DrinkingBlood TransfusionColectomyColonColonic DiseasesColorectal NeoplasmsFemaleHumansMaleMiddle AgedMultivariate AnalysisNeoadjuvant TherapyPostoperative ComplicationsRadiation InjuriesRectal DiseasesRectumRetrospective StudiesRisk FactorsSurgical StaplersSurgical Wound DehiscenceSuture TechniquesYoung Adult