Factors Influencing Leaks in Primary Intestinal Anastomoses: An Observational Study

Background An anastomotic leak (AL) remains a major complication in gastrointestinal surgery, particularly after primary intestinal anastomosis. It contributes to increased morbidity, prolonged hospitalization, and mortality. Objective To identify and evaluate patient, surgical, and perioperative factors associated with the development of anastomotic leaks in individuals undergoing a primary intestinal anastomosis. Methods This observational study was conducted at Sree Balaji Medical College and Hospital, Chennai, and included 70 patients who underwent primary intestinal anastomosis. Data were collected on demographics, comorbidities, surgical details, postoperative outcomes, and complications. Statistical analyses included logistic regression and receiver operating characteristic (ROC) analysis to assess predictive factors. Results The overall incidence of AL was 23.3% (14 out of 70 patients). Higher BMI (p = 0.005), renal disease (p = 0.043; 7 out of 9 patients with renal disease), hypertension (p = 0.041; 5 out of 6 patients), and diabetes (p = 0.029; 5 out of 7 diabetic patients) were significantly associated with AL. Logistic regression showed BMI to be an independent predictor of AL. An ROC analysis indicated predictive utility for BMI and CRP. No significant associations were found with age, gender, smoking, surgical duration, or blood loss. Conclusion BMI and comorbidities such as renal disease, hypertension, and diabetes are key risk factors for AL. Preoperative optimization and risk stratification based on these factors can improve surgical outcomes. Future studies should validate these findings in larger, multicentric populations.