Early predictors of anastomotic leaks after colectomy

Tech Coloproctol. 2009 Mar;13(1):41-7. doi: 10.1007/s10151-009-0457-7. Epub 2009 Mar 14.


Background: An anastomotic leak after colorectal surgery is associated with significant morbidity and decreased survival. Our aim was to identify the early predictors of anastomotic leaks.

Methods: The records of patients undergoing restorative resection for colorectal disease from January 2000 to November 2005 were reviewed. Demographics, clinical events, and laboratory parameters were recorded.

Results: A total of 311 patients were included. An anastomotic leak was identified in 25 patients (8%). A leak was suspected and diagnosis confirmed at a mean of 10+/-1 days postoperatively. More respiratory and neurological events occurred in patients with an anastomotic leak (p<0.001). These events occurred early in the postoperative course and were usually the first signs and symptoms of a leak. More patients with a leak had absence of bowel activity by postoperative day 6 compared to patients without a leak (p<0.0001). Elevations of the white blood cell count or temperature were a late finding.

Conclusion: The earliest clinical predictors of an anastomotic leak are pulmonary and/or neurological. Awareness of these findings might help in early diagnosis and treatment of an anastomotic leak.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Colectomy / methods*
  • Colon / surgery*
  • Colonic Diseases / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Rectal Diseases / surgery*
  • Rectum / surgery*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Treatment Outcome
  • United States / epidemiology