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    Anastomotic leaks in colorectal surgery

    203540_203540.pdf (852.1Kb)
    Access Status
    Open access
    Authors
    Damen, N.
    Spilsbury, Katrina
    Levitt, M.
    Makin, G.
    Salama, P.
    Tan, P.
    Penter, C.
    Platell, C.
    Date
    2014
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Damen, N. and Spilsbury, K. and Levitt, M. and Makin, G. and Salama, P. and Tan, P. and Penter, C. et al. 2014. Anastomotic leaks in colorectal surgery. ANZ Journal of Surgery. 84 (10): pp. 763-768.
    Source Title
    ANZ Journal of Surgery
    DOI
    10.1111/ans.12494
    ISSN
    1445-2197
    School
    Centre for Population Health
    Remarks

    This is the accepted version of the following article: Damen, N. and Spilsbury, K. and Levitt, M. and Makin, G. and Salama, P. and Tan, P. and Penter, C. et al. 2014. Anastomotic leaks in colorectal surgery. ANZ Journal of Surgery. 84 (10): pp. 763-768, which has been published in final form at http://doi.org/10.1111/ans.12494

    URI
    http://hdl.handle.net/20.500.11937/5956
    Collection
    • Curtin Research Publications
    Abstract

    Background: Anastomotic leaks are a serious complication of bowel surgery. This study aimed to evaluate the rate and severity, and identify risk factors for leaks in patients undergoing bowel anastomoses. Methods: Prospective evaluation was performed on patients undergoing bowel surgery within a colorectal surgical unit. Anastomotic leak was defined and graded according to severity. A nurse independently collected the information. Stepwise logistic regression analysis was performed. Results: Two thousand three hundred and sixty-three patients underwent 2994 anastomoses. Their median age was 64 years. Seven per cent were emergency operations. Anastomotic leak occurred in 82 patients (2.7%). Sixty-three per cent of leaks were managed with drainage or re-operation. Ultra-low anterior resection (ULAR) was associated with the highest subgroup leak rate (7.3%). In multivariable analysis, independent predictors for a leak included ‘other’ pathologies (iatrogenic injury, ischaemia, radiation enteritis) (P = 0.016, odds ratio (OR): 6.3, 95% confidence interval (CI): 1.4–28.0), ULAR (P = 0.001, OR: 8.5, 95% CI: 2.3–31.2) and the surgeon (A: P < 0.001, OR: 3.4, 95% CI: 2.1–5.6). Conclusion: Majority of predictors for anastomotic leak were fairly intuitive. Nonetheless, it was relevant to note the importance of the individual surgeon as an independent predictor for leaks.

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