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Updated: May 3, 2026

The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
Anastomotic leaks in colorectal surgery
Nikki Damen1, Katrina Spilsbury, Michael Levitt
1Colorectal Surgical Unit, St John of God Hospital Subiaco, Perth, Western Australia, Australia.
Background:
Anastomotic leaks are a serious complication of bowel surgery. This study aimed to evaluate the rate and severity, and identify risk factors for leaks in patients undergoing bowel anastomoses.
Methods:
Prospective evaluation was performed on patients undergoing bowel surgery within a colorectal surgical unit. Anastomotic leak was defined and graded according to severity. A nurse independently collected the information. Stepwise logistic regression analysis was performed.
Results:
Two thousand three hundred and sixty-three patients underwent 2994 anastomoses. Their median age was 64 years. Seven per cent were emergency operations. Anastomotic leak occurred in 82 patients (2.7%). Sixty-three per cent of leaks were managed with drainage or re-operation. Ultra-low anterior resection (ULAR) was associated with the highest subgroup leak rate (7.3%). In multivariable analysis, independent predictors for a leak included 'other' pathologies (iatrogenic injury, ischaemia, radiation enteritis) (P=0.016, odds ratio (OR): 6.3, 95% confidence interval (CI): 1.4-28.0), ULAR (P=0.001, OR: 8.5, 95% CI: 2.3-31.2) and the surgeon (A: P<0.001, OR: 3.4, 95% CI: 2.1-5.6).
Conclusion:
Majority of predictors for anastomotic leak were fairly intuitive. Nonetheless, it was relevant to note the importance of the individual surgeon as an independent predictor for leaks.
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