Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2009
[Anastomotic leakage following bowel resections for colon cancer: multivariate analysis of risk factors].
Аннотация на английскомСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Kube R, Mroczkowski P, Steinert R, Sahm M, Schmidt U, Gastinger I, Lippert H
Аннотация
BACKGROUND: The aim of this study was to evaluate the incidence and risk factors associated with anastomotic leakage after colon cancer surgery using data compiled in the nationwide German qualitative multi-center study "Colon/Rectum Cancer" (WGCRC).
METHODS: From 01/01/2000 to 12/31/2004 data recorded from patients with anastomotic leakages were evaluated to determine independent predictors of leakage using logistic regression analysis.
RESULTS: A total of 28,271 patients underwent colon resection with anastomoses and anastomotic leaks occurred in 3.0% (n=844). Multivariate analysis identified long duration of surgery, a high ASA score, male gender, obstruction, left-sided tumor, cardiovascular hepatic comorbidity, single-layer hand suture, anastomoses using the biofragmentable Valtrac ring, intraoperative complications and BMI>30 kg/m(2) as risk factors for postoperative occurrence of anastomotic leakage.
CONCLUSIONS: Even though the rate of anastomotic leaks in patients with anastomoses after resection for colon cancer is low, it remains a significant complication, associated with significant morbidity and mortality. The knowledge of risk factors should be considered in perioperative decision-making regarding anastomotic technique and indications for Hartmann's procedure.
METHODS: From 01/01/2000 to 12/31/2004 data recorded from patients with anastomotic leakages were evaluated to determine independent predictors of leakage using logistic regression analysis.
RESULTS: A total of 28,271 patients underwent colon resection with anastomoses and anastomotic leaks occurred in 3.0% (n=844). Multivariate analysis identified long duration of surgery, a high ASA score, male gender, obstruction, left-sided tumor, cardiovascular hepatic comorbidity, single-layer hand suture, anastomoses using the biofragmentable Valtrac ring, intraoperative complications and BMI>30 kg/m(2) as risk factors for postoperative occurrence of anastomotic leakage.
CONCLUSIONS: Even though the rate of anastomotic leaks in patients with anastomoses after resection for colon cancer is low, it remains a significant complication, associated with significant morbidity and mortality. The knowledge of risk factors should be considered in perioperative decision-making regarding anastomotic technique and indications for Hartmann's procedure.