Predictive factors for anastomotic leak in small bowel and large bowel anastomosis: A Multivariate analysis at K R hospital Mysore

Abstract

Background: Intestinal anastomosis is an operative procedure to establish communication between two formerly distant parts of the intestine. The procedure restores bowel continuity after elimination of the pathological condition affecting the intestines. Objective: to determine the incidence of Anastomotic leak in patients undergoing intestinal resection and bowel anastomosis, to study the association between multiple predictive risk factors and Anastomotic leak and to determine the Mortality rate associated with Anastomotic Leak. Materials and methods: This prospective hospital-based study involved all the patients undergoing Intestinal Resection and Anastomosis due to various clinical conditions at K R Hospital attached to Mysore Medical College and Research Institute from 1st December 2018 to 31st July 2020. Total of 73 patients undergoing Small and Large bowel anastomosis for various indications were studied. Results: Out of 73 patients, 58 of them underwent emergency surgery and 15 of them had elective surgery. In this study 46 patients underwent small bowel anastomosis, 24 had io colic anastomosis and remaining 7 had large bowel anastomosis. Predicative factors significantly associated with AL were male gender, CLD, multiple comorbidities, emergent anastomoses, colonic anastomoses, preoperative leukocytosis, and intraoperative blood transfusion. The anastomotic leak incidence was 16.4%.Conclusion: Intestinal anastomosis carries with it considerable mortality and the morbidity. Malnourished and preoperative leucocytosis patients are at a greater risk for developing anastomotic leak, SSI, burst abdomen & mortality following bowel anastomosis.