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The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study
BACKGROUND: Anastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of de...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789647/ https://www.ncbi.nlm.nih.gov/pubmed/33413244 http://dx.doi.org/10.1186/s12893-020-01044-8 |
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author | Awad, Selmy El-Rahman, Ahmed Ibrahim Abd Abbas, Ashraf Althobaiti, Waleed Alfaran, Shaker Alghamdi, Saleh Alharthi, Saleh Alsubaie, Khaled Ghedan, Soliman Alharthi, Rayan Asiri, Majed Alzahrani, Azzah Alotaibi, Nawal Shoma, Ashraf Sheishaa, Mohamed Samir Abou |
author_facet | Awad, Selmy El-Rahman, Ahmed Ibrahim Abd Abbas, Ashraf Althobaiti, Waleed Alfaran, Shaker Alghamdi, Saleh Alharthi, Saleh Alsubaie, Khaled Ghedan, Soliman Alharthi, Rayan Asiri, Majed Alzahrani, Azzah Alotaibi, Nawal Shoma, Ashraf Sheishaa, Mohamed Samir Abou |
author_sort | Awad, Selmy |
collection | PubMed |
description | BACKGROUND: Anastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of detected leaks. The purpose of the research was to assess the perioperative risk factors for AL. METHODS: This study was achieved at MUH and MIH/Egypt within the period between January 2016 and January 2019 for the candidates who underwent bowel anastomosis for small intestinal (except duodenal one) and colorectal pathology. The collected data were analyzed using SPSS of V-26. RESULTS: This study included 315 cases, among them, 27 cases (8.57%) developed AL. The percentage of covering stoma was significantly higher in the non-leakage group vs leakage one (24.3% vs 11.1% respectively). lower albumin, operative timing, perforation, and covering stoma were shown as significant risk factors for leakage, but with multivariate analysis for these factors, the emergency operation, and serum albumin level was the only independent risk factors that revealed the significance consequently (p = 0.043, p = 0.015). The analysis of different predictors of AL on the third day showed that the cut-off point in RR was 29 with 83% sensitivity and 92% specificity in prediction of leakage, the cut-off point in RR was 118 with 74% sensitivity and 87% specificity in prediction of leakage and the cut-off point in CRP was 184.7 with 82% sensitivity and 88% specificity in prediction of AL and all had statistically significant value. CONCLUSIONS: The preoperative serum albumin level and the emergency operations are independent risk factors for anastomotic leakage. Moreover, leakage should be highly suspected in cases with rising respiratory rate, heart rate, and CRP levels. |
format | Online Article Text |
id | pubmed-7789647 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77896472021-01-07 The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study Awad, Selmy El-Rahman, Ahmed Ibrahim Abd Abbas, Ashraf Althobaiti, Waleed Alfaran, Shaker Alghamdi, Saleh Alharthi, Saleh Alsubaie, Khaled Ghedan, Soliman Alharthi, Rayan Asiri, Majed Alzahrani, Azzah Alotaibi, Nawal Shoma, Ashraf Sheishaa, Mohamed Samir Abou BMC Surg Research Article BACKGROUND: Anastomotic leaks (AL) are among the most serious complications due to the substantial impact on the quality of life and mortality. Inspite of the advance in diagnostic tools such as laboratory tests and radiological adjuncts, only moderate improvement has been recorded in the rate of detected leaks. The purpose of the research was to assess the perioperative risk factors for AL. METHODS: This study was achieved at MUH and MIH/Egypt within the period between January 2016 and January 2019 for the candidates who underwent bowel anastomosis for small intestinal (except duodenal one) and colorectal pathology. The collected data were analyzed using SPSS of V-26. RESULTS: This study included 315 cases, among them, 27 cases (8.57%) developed AL. The percentage of covering stoma was significantly higher in the non-leakage group vs leakage one (24.3% vs 11.1% respectively). lower albumin, operative timing, perforation, and covering stoma were shown as significant risk factors for leakage, but with multivariate analysis for these factors, the emergency operation, and serum albumin level was the only independent risk factors that revealed the significance consequently (p = 0.043, p = 0.015). The analysis of different predictors of AL on the third day showed that the cut-off point in RR was 29 with 83% sensitivity and 92% specificity in prediction of leakage, the cut-off point in RR was 118 with 74% sensitivity and 87% specificity in prediction of leakage and the cut-off point in CRP was 184.7 with 82% sensitivity and 88% specificity in prediction of AL and all had statistically significant value. CONCLUSIONS: The preoperative serum albumin level and the emergency operations are independent risk factors for anastomotic leakage. Moreover, leakage should be highly suspected in cases with rising respiratory rate, heart rate, and CRP levels. BioMed Central 2021-01-07 /pmc/articles/PMC7789647/ /pubmed/33413244 http://dx.doi.org/10.1186/s12893-020-01044-8 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Awad, Selmy El-Rahman, Ahmed Ibrahim Abd Abbas, Ashraf Althobaiti, Waleed Alfaran, Shaker Alghamdi, Saleh Alharthi, Saleh Alsubaie, Khaled Ghedan, Soliman Alharthi, Rayan Asiri, Majed Alzahrani, Azzah Alotaibi, Nawal Shoma, Ashraf Sheishaa, Mohamed Samir Abou The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title | The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title_full | The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title_fullStr | The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title_full_unstemmed | The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title_short | The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
title_sort | assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789647/ https://www.ncbi.nlm.nih.gov/pubmed/33413244 http://dx.doi.org/10.1186/s12893-020-01044-8 |
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