A clinical study on factors predisposing to anastomotic leak

Abstract

Anastomotic leaks represent a significant complication in intestinal surgery, leading to increased morbidity and mortality. This clinical study aimed to identify factors predisposing patients to anastomotic leaks. Conducted prospectively from August 2022 to January 2023 at Rangaraya Medical College, the study included 151 cases of intestinal resection and anastomosis. Factors were categorized into patient-related, surgery-related, and postoperative categories. The analysis revealed that age, nutritional status, and pre-existing conditions like diabetes and chronic corticosteroid use significantly impacted leak rates. Older patients and those with poor nutritional status exhibited higher leak incidences. Chronic corticosteroid therapy was strongly associated with an increased risk of leaks (P < 0.001), while preoperative hemoglobin levels also showed significant correlation (P < 0.05). Surgery-related factors, including the type and duration of the procedure and intraoperative blood loss, were found to influence outcomes significantly. Longer surgeries and those with substantial blood loss had higher leak rates. Postoperative care, particularly nutritional support and early detection of complications, was critical in mitigating leak risks. The timely management of complications and the provision of adequate nutrition were crucial for better recovery and reduced leak rates. Statistical analysis, including chi-square and multivariate logistic regression, underscored the significance of these associations. The study highlights the importance of a comprehensive, multidisciplinary approach to patient care, encompassing preoperative optimization, meticulous surgical techniques, and vigilant postoperative management to reduce the incidence of anastomotic leaks. These findings suggest that targeted interventions in these key areas could significantly improve surgical outcomes and patient safety. In conclusion, a holistic approach to patient management, addressing both preoperative and postoperative factors, is essential in minimizing the risk of anastomotic leaks and enhancing overall patient outcomes.