Ileocolic anastomosis dehiscence in colorectal cancer surgery

Abstract

Background: Anastomotic leakage (AL) is one of the most feared complications in colorectal cancer (CRC) surgery. Although many series have reported the general risk factors for AL, published studies focusing on ileocolic anastomosis are scarce. The main aim of this study was to identify potential risk factors associated with ileocolic anastomosis dehiscence in surgery for CRC. Methods: A total of 188 patients who underwent primary ileocolic anastomosis after elective CRC surgery in Braga’s Hospital from November of 2018 to February of 2022 were included. A multivariate logistic regression analysis was carried out to identify independent risk factors for AL. Results: AL occurred in 13 patients (6.9%), and about three-fourths of these patients required surgical re-intervention. The mortality rate was 5.3%. Diabetes mellitus, ASA score of ≥3, laparotomy or conversion to laparotomy approach, postoperative blood transfusion, and postoperative hypoalbuminemia were associated with an increased risk of AL. In the multivariable analysis, postoperative hypoalbuminemia (p = 0.018; OR: 0.281; CI: 0.098; 0.806) and shorter operating time (p = 0.038; OR: 0.985; CI: 0.972; 0.999) were independent risk factors for AL. Conclusions: Postoperative hypoalbuminemia and shorter operating time are independent risk factors for AL after ileocolic anastomosis.