Assessing abdominal aortic calcifications before performing colocolic or colorectal anastomoses: A case-control study

Area of Science:

• Vascular Surgery
• Gastroenterology
• Radiology

Background:

• Objective risk assessment is crucial for preventing anastomotic leakage (AL) after colorectal surgery.
• Cardiovascular disease, indicated by abdominal aortic calcification (AAC), is a potential risk factor for AL.
• This study investigated the association between AAC and AL in patients undergoing colorectal anastomosis.

Purpose of the Study:

• To determine if abdominal aortic calcification (AAC) is associated with an increased risk of anastomotic leakage (AL) following colorectal surgery.
• To evaluate AAC as a potential objective marker for preoperative risk stratification in patients undergoing colorectal anastomosis.

Main Methods:

• A retrospective case-control study was conducted involving patients who underwent colorectal anastomosis between 2012 and 2016.
• Abdominal aortic calcification (AAC) levels were measured and compared between patients with AL (cases) and those without AL (controls).
• Multivariate logistic regression models were used to identify independent risk factors for AL, analyzing AAC as both a continuous and a qualitative (≥5%) variable.

Main Results:

• The study included 45 cases with AL and 116 controls without AL.
• Patients with AL exhibited significantly higher rates of abdominal aortic calcification (AAC) compared to controls (4.4% vs. 2.5%).
• Multivariate analysis confirmed that AAC (continuous variable, aOR=1.8) and AAC ≥5% (qualitative variable, aOR=3.2) were independent predictors of AL.

Conclusions:

• An abdominal aortic calcification (AAC) rate of 5% or higher is a significant indicator of increased anastomotic leakage (AL) risk.
• AAC assessment should be considered in preoperative evaluations to inform surgical decisions regarding colorectal anastomosis.
• Identifying patients with high AAC may help mitigate AL complications through tailored surgical planning.