Anastomotic leak in colorectal surgery: are 75 % preventable?

Abstract

Anastomotic leak (AL) is a significant cause of morbidity and mortality associated with complications of colorectal surgery. Furthermore, AL results in prolonged hospital stays and significant increase in costs of medical resources. In this study, we investigated the impact of anastomosis technique on the rate of anastomotic leak. The rate of leak was compared between two groups performing end-to-end (E-E) vs. side-to-end (S-E) anastomosis. The impact of various risk factors was also compared between the two groups. There were 382 E-E and 363 S-E anastomoses after left colectomy or rectal resections. The anastomotic leak rate was 8.64 % using E-E compared to 1.93 % using S-E anastomosis technique (p < 0.001). These results indicate that the rate of anastomotic leak after left colon and rectum resections could be significantly reduced utilizing S-E anastomosis technique.