Anastomotic leak in colorectal surgery: are 75 % preventable?

Introduction: Anastomotic leak (AL) is a significant cause of morbidity and mortality associated with complications of colorectal surgery. Furthermore, AL results in prolonged hospital stays and significant increase in costs of medical resources.

Materials And Methods: In this study, we investigated the impact of anastomosis technique on the rate of anastomotic leak. The rate of leak was compared between two groups performing end-to-end (E-E) vs. side-to-end (S-E) anastomosis. The impact of various risk factors was also compared between the two groups.

Results: There were 382 E-E and 363 S-E anastomoses after left colectomy or rectal resections. The anastomotic leak rate was 8.64 % using E-E compared to 1.93 % using S-E anastomosis technique (p < 0.001).

Conclusions: These results indicate that the rate of anastomotic leak after left colon and rectum resections could be significantly reduced utilizing S-E anastomosis technique.