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Risk factors for anastomotic leakage following ileosigmoid or ileorectal anastomosis
Karolinska Inst, Sweden; Ersta Hosp, Sweden.
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
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2018 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 20, no 4, p. 304-311Article in journal (Refereed) Published
Abstract [en]

Aim

Reconstruction with an ileosigmoidal anastomosis (ISA) or ileorectal anastomosis (IRA) is a surgical option after a subtotal colectomy. Anastomotic leakage (AL) is a problematic complication and high rates have been reported, but there is limited understanding of the risk factors involved. The aim of this study was to assess the established and potential predictors of AL following ISA and IRA.

Method

This was a retrospective cohort study including all patients who had undergone ISA or IRA at three Swedish referral centres for colorectal surgery between January 2007 and March 2015. Data regarding clinical characteristics, treatment and outcome were collected from medical records. Univariate and multivariate logistic regression models were used to determine the association between patient and treatment related factors and the cumulative incidence of AL.

Results

In total, 227 patients were included. Overall, AL was detected amongst 30 patients (13.2%). Amongst patients undergoing colectomy with synchronous ISA or IRA (one‐stage procedure), AL occurred in 23 out of 120 (19.2%) compared with seven out of 107 (6.5%) after stoma reversal with ISA or IRA (two‐stage procedure) (= 0.004). In addition, the multivariate analyses revealed a statistically significantly lower odds ratio for AL following a two‐stage procedure (OR 0.10, 95% CI 0.03–0.41, = 0.001).

Conclusions

This study confirms high rates of AL following ISA and IRA. In particular, a synchronous procedure with colectomy and ISA/IRA carries a high risk of AL.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2018. Vol. 20, no 4, p. 304-311
Keywords [en]
Ileorectal anastomosis; anastomotic leakage; risk factors
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-147576DOI: 10.1111/codi.13938ISI: 000428991400008PubMedID: 29059489Scopus ID: 2-s2.0-85044722739OAI: oai:DiVA.org:liu-147576DiVA, id: diva2:1201827
Note

Funding Agencies|Stockholm Community Council; Karolinska Institutet; Bengt Ihre Foundation; Bengt Ihre Research Fellowship

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-05-03Bibliographically approved

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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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