Risk factors of anastomotic leakage in colon cancer

To analyze the risk factors for anastomosis leak in colon cancer surgery (CCS) in our environment, and developed a predictive equation for that risk.

We performed a case-control study nested in a cohort of 576 consecutive patients undergoing colon cancer surgery with primary anastomosis, univariate statistical tests and univariate logistic regression for statistical analysis of associated factors with anastomosis leak in colon cancer surgery, and multivariate logistic regression for predicting that risk using a predictive equation associated with a ROC curve.

We obtained a higher risk of anastomosis leak in patients whose operative time was longer than 180 minutes. The variables: preoperative transfusion, previous pathologies, nutritional status, approach, surgical technique or age do not influence the development of this complication. The equation found has a sensitivity of 64.1% and a specificity of 67.5%.

Operation time longer than 180 minutes was the main risk factor for anastomosis leak. Our equation can hardly predict this risk. After further validation, our results may help the surgeon make a more individualized, safer decision regarding whether to perform an anastomosis or make a stoma.