Purpose: The purpose of our study was to investigate preoperative and intraoperative risk factors for anastomotic leak (AL) after elective colorectal resections performed for malignancies. In addition, we studied some features of postoperative recovery and their influence on AL occurrence.

Methods: We retrospectively reviewed the records of patients that underwent colorectal surgical procedures for malignancies between January 2013 and December 20017 in a single institution. Only procedures with primary anastomosis were included.

Results: Of the 153 patients, 56.2% were male. The mean age was 67.5 years. AL occurred in 15 patients (9.8%). In univariate analysis, multiorgan resection, delayed postoperative bowel movement and delayed onset of per oral intake were significantly correlated with AL. Gender, preoperative albumin level, primary cancer site and surgery duration did not have significant correlation with AL.

Conclusions: Risk factors described in the literature of the 20th century are no longer current. The main findings that feature postoperative recovery were associated with increased risk of AL and should be more carefully investigated in further studies which could lead towards the development of new specific post-operative protocols.

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