The risk factors and predictive factors for anastomotic leakage after resection for colorectal cancer: reappraisal of the literature

Anastomotic leakage is a serious complication that can occur after colorectal surgery. Several risk factors for anastomotic leakage have been reported based on the findings of prospective and retrospective studies, including patient characteristics, the use of neoadjuvant therapy, the tumor location, intraoperative events, etc. However, as these risk factors affect each other, the statistical results have differed in each study. In addition, differences in surgical methods, including laparoscopy versus laparotomy or stapling anastomosis versus handsewn anastomosis, may influence the incidence of anastomotic leakage. This mini-review summarizes the results of reported papers to clarify the current evidence of risk factors for anastomotic leakage

Analysis of Surgical Risk Factors in Tailoring Digestive Anastomosis

Gastrointestinal anastomosis leakage is still the major complication following abdominal surgery. Many conditions including hypoalbuminemia, chronic obstructive pulmonary disease, hypovolemia, anemia, and hypoxemia, prolonged operative time, blood loss, blood transfusions, colon cancer, and inflammatory bowel disease have been identified as significant risk factors. Despite the improved perioperative assessment, the standardization of surgical technique, and the use of innovative devices, the incidence of gastrointestinal anastomosis leakage ranges from 2 to 12 %. We performed experimental studies comparing from a biochemical point of view, and from a tensiometric one in vitro, segments of small and large bowel resected and anastomosed. In the second phase of our experimental trials, we investigated if the biochemical differences between small and large bowel were associated with differences in motility and peristalsis. In the further step, we investigated if the pericardium bovine patch wrapping ileoileal and colocolonic hand-sewn anastomosis in pigs seals the suture line and promotes anastomotic healing