Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery
Purpose. Liver cirrhosis associated with high perioperative morbidity/mortality. This retrospective study determines whether liver cirrhosis represents a risk factor for anastomotic leakage after colonic anastomosis or not. Methods. Based on a prospective database with all consecutive colorectal res...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2016/1563037 |
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| author | Samuel Andreas Käser Irina Hofmann Niels Willi Felix Stickel Christoph Andreas Maurer |
| author_facet | Samuel Andreas Käser Irina Hofmann Niels Willi Felix Stickel Christoph Andreas Maurer |
| author_sort | Samuel Andreas Käser |
| collection | DOAJ |
| description | Purpose. Liver cirrhosis associated with high perioperative morbidity/mortality. This retrospective study determines whether liver cirrhosis represents a risk factor for anastomotic leakage after colonic anastomosis or not. Methods. Based on a prospective database with all consecutive colorectal resections performed at the authors’ institution from 07/2002 to 07/2012 (n=2104) all colonic and rectal anastomoses were identified (n=1875). A temporary loop ileostomy was constructed in 257 cases (13.7%) either due to Mannheimer Peritonitis-Index > 29 or rectal anastomosis below 6 cm from the anal verge. More than one-third of the patients (n=691) had postoperative contrast enema, either at the occasion of another study or prior to closure of ileostomy. The presence of liver cirrhosis and the development of anastomotic leakage were assessed by chart review. Results. The overall anastomotic leakage rate was 2.7% (50/1875). In patients with cirrhosis/severe fibrosis, the anastomotic leakage rate was 12.5% (3/24), while it was only 2.5% (47/1851) in those without (p=0.024). The difference remained statistically significant after correction for confounding factors by multivariate analysis. Conclusion. Patients with liver cirrhosis/severe fibrosis have an increased risk of leakage after colonic anastomosis. |
| format | Article |
| id | doaj-art-711a95a6534b40e09b92321ee645121b |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-711a95a6534b40e09b92321ee645121b2025-02-03T01:20:40ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/15630371563037Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal SurgerySamuel Andreas Käser0Irina Hofmann1Niels Willi2Felix Stickel3Christoph Andreas Maurer4Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Rheinstrasse 26, 4410 Liestal, SwitzerlandDepartment of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Rheinstrasse 26, 4410 Liestal, SwitzerlandInstitute of Pathology, Mühlemattstrasse 11, 4410 Liestal, SwitzerlandDepartment of Gastroenterology, Hirslanden-Clinic Beau-Site, Schänzlihalde 1, 3000 Bern-25, 3013 Bern, SwitzerlandDepartment of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Rheinstrasse 26, 4410 Liestal, SwitzerlandPurpose. Liver cirrhosis associated with high perioperative morbidity/mortality. This retrospective study determines whether liver cirrhosis represents a risk factor for anastomotic leakage after colonic anastomosis or not. Methods. Based on a prospective database with all consecutive colorectal resections performed at the authors’ institution from 07/2002 to 07/2012 (n=2104) all colonic and rectal anastomoses were identified (n=1875). A temporary loop ileostomy was constructed in 257 cases (13.7%) either due to Mannheimer Peritonitis-Index > 29 or rectal anastomosis below 6 cm from the anal verge. More than one-third of the patients (n=691) had postoperative contrast enema, either at the occasion of another study or prior to closure of ileostomy. The presence of liver cirrhosis and the development of anastomotic leakage were assessed by chart review. Results. The overall anastomotic leakage rate was 2.7% (50/1875). In patients with cirrhosis/severe fibrosis, the anastomotic leakage rate was 12.5% (3/24), while it was only 2.5% (47/1851) in those without (p=0.024). The difference remained statistically significant after correction for confounding factors by multivariate analysis. Conclusion. Patients with liver cirrhosis/severe fibrosis have an increased risk of leakage after colonic anastomosis.http://dx.doi.org/10.1155/2016/1563037 |
| spellingShingle | Samuel Andreas Käser Irina Hofmann Niels Willi Felix Stickel Christoph Andreas Maurer Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery Gastroenterology Research and Practice |
| title | Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery |
| title_full | Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery |
| title_fullStr | Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery |
| title_full_unstemmed | Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery |
| title_short | Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery |
| title_sort | liver cirrhosis severe fibrosis is a risk factor for anastomotic leakage after colorectal surgery |
| url | http://dx.doi.org/10.1155/2016/1563037 |
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