Revista chilena de cirugía
versión On-line ISSN 0718-4026
BANNURA C, GUILLERMO et al. Risk factors for dehiscence of stapled colorectal anastomosis. Rev Chil Cir [online]. 2007, vol.59, n.4, pp.287-292. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262007000400008.
Background: Dehiscence of colorectal anastomoses are associated with high rates of mortality and complications. Aim: To analyze the factors that predict dehiscence of stapled colorectal anastomoses. Material and methods: Prospective study of 380 patients aged 16 to 88 years (198 females). A logistic regression model was used to assess the association of anastomoses dehiscence and seventeen variables. Results: Eighteen patients (5%) had a dehiscence. This complication occurred in 6 of 295 high colorectal anastomoses (2%) and in 12 of 85 low colorectal anastomoses (14%, p< 0.001). Ten patients required a new operation and eight were managed conservatively. Five patients died (1.3%) and in two of these the dehiscence was the cause of death. Among patients with and without anastomotic dehiscence, the rate of re operation was 3.8 and 56% respectively (p< 0.01), wound infections occurred in 6 and 50% respectively (p< 0.01), mean hospital stay was 10.7 and 27.9 days respectively (p< 0.01) and operative mortality was 0.5 and 11 % respectively (p< 0.01). Multivariate analysis disclosed male gender, height of anastomosis and a history of pelvic radiation as predictive variables for anastomotic dehiscence. Conclusions: Anastomoses performed at less than 8 cm from the anal margin, preoperative radiation and male gender are risk factors for anastomotic dehiscence
Palabras clave : Stapled anastomosis; dehiscence; colorectal surgery.