Longer Operative Time and Intraoperative Blood Transfusion Are Associated with Postoperative Anastomotic Leak after Lower Gastrointestinal Surgery. Am Surg 2019 Feb 01;85(2):136-141
Date
03/02/2019Pubmed ID
30819288Scopus ID
2-s2.0-85062382468 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
Anastomotic leak after lower gastrointestinal surgery is a complication with potential for high morbidity, mortality, and increased costs. A single-institution retrospective chart review was performed on all patients who underwent lower gastrointestinal surgery between June 2009 and June 2013. Fifty-seven variables were included in our analysis and their association with postoperative anastomotic leak was examined. Nine hundred fifty-two patients underwent 983 lower gastrointestinal anastomoses with an overall leak rate in this series of 6 per cent. Type of intestinal anastomosis created (P < 0.00005), operative indication (P < 0.015), operation performed (P < 0.014), intraoperative blood transfusion (P < 0.017), and intraoperative surgical drain placement (P < 0.022) were all predictive of anastomotic leak. Anastomotic leak rate increased by 1.3 times for every additional hour in the operating room after three hours. Both increasing operation time and intraoperative blood transfusions were associated with an increased rate of anastomotic leak. When operative time extends beyond three hours or in those cases were blood transfusions are given, surgeons should consider taking steps to minimize the risks of a potential anastomotic leak.
Author List
Cortina CS, Alex GC, Vercillo KN, Fleetwood VA, Smolevitz JB, Poirier J, Myers JA, Orkin BA, Singer MAAuthor
Chandler S. Cortina MD Assistant Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anastomotic LeakBlood Transfusion
Digestive System Surgical Procedures
Female
Humans
Intestinal Diseases
Intraoperative Care
Male
Operative Time
Retrospective Studies
Risk Factors
