Factors predicting leakage in emergency small bowel anastomosis / Mohamed Mansour Megahed Saleh ; Supervised Hisham Ahmed Aboueisha , Hesham Nabil Abdelmooty , Hussein Ossama Elwan

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of General Surgery

Background: Anastomotic leak is a dreaded complication of intestinal surgery and has been associated with a high mortality rate. There is a great deal of conflicting data regarding risk factors for anastomotic leakage, with most studies being small and looking only at anastomoses performed at one level of the gastrointestinal (GI) tract. The purpose of this study was to evaluate the possible predictive factors of anastomotic dehiscence in patients undergoing resection anastomotic operations at the levels of the small intestine. Objectives: The objective of this study was to identify risk factors associated with intestinal anastomotic leakage in order to practically assist in surgical decision making. Results: A total of fifty one emergency patients meeting the inclusion criteria underwent resection with anastomosis during the study period. There were 13/51 patients with leaks (25.4%),4 of whom died. In bivariate analysis, factors that were associated with anastomotic leaks were; advancing age, hypoalbuminemia (serum albumin <3(g/dl) 12/13 (92.3%), intra-operative hypovolaemia 8/13 (61.5%), intraoperative hypotension (systolic blood pressure below 80 mm Hg), diffuse peritonitis and low hemoglobin concentration (less than 10g %), all have a great association with anastomotic leakage. Mortality was significantly increased in patients with AL, we had 4 cases of mortality (3 males and 1 females), 4/51 (7.843%) of which had AL (3/13 {u2013} 23.07%) died in the postoperative period due to sepsis related multiorgan failure following anastomotic dehiscence.

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