The aortic calcification is a risk factor for colorectal anastomotic leakage.

Purpose: The current pooling up analysis aimed to evaluate whether aortic calcification (AC) was a potential risk factor for anastomotic leakage (AL) after colorectal surgery.

Methods: In this study, we searched studies in three databases including PubMed, Embase, and the Cochrane Library on April 20, 2022. In order to investigate the association between AC and AL, the hazard ratios (HRs) and 95% confidence intervals (CIs) of AC were pooled up. Our study was performed with RevMan 5.3 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results: We finally enrolled eight studies involving 1955 patients for statistical analysis. As for all patients, we found that AC could significantly increase the risk of AL after surgery (HR = 2.31, I = 0%, 95%CI = 1.58 to 3.38, P < 0.01). In five studies including patients undergoing colorectal surgery (benign diseases and cancers), AC was also a risk factor for AL (HR = 3.30, I = 2%; 95%CI = 1.83 to 5.95, P < 0.01). In terms of the other three studies that only included CRC patients, there was still a correction between AC and AL (HR = 1.80, I = 0%, 95%CI = 1.10 to 2.96, P = 0.02).

Conclusion: Patients with AC were more likely to develop AL after colorectal surgery. Moreover, subgroup analysis suggested that AC was a predictor for AL after CRC surgery.