A Study on Risk Factors Associated with Anastomotic Leakage in Gastrointestinal Surgeries

Abstract

Aims: To study the risk factors associated with anastomotic leakage in Gastrointestinal surgery and to study the measures by which these complications can be minimized and managed in a better way. Study Design: This was a prospective observational study. Place and Duration of Study: Conducted in the Post Graduate Department of Surgery, Government Medical College Jammu, over a period of one year from 1st November 2019 to 31st October 2020. Methodology: 102 patients who had undergone gastrointestinal anastomosis irrespective of age and gender were included in the study. The patients were thoroughly evaluated and pre operative and post operative details were noted followed by analysis of risk factors associated with those who had anastomotic leaks pos operatively were analysed and results obtained. Results: Distribution of anastomotic leak was comparable in elective and emergency (5.06% v/s8.70% respectively) .Proportion of anastomotic leak was significantly higher in >25 body mass index as compared to <25 body mass index (27.27% v/s3.30% respectively, significantly higher in anaemic (Hb<10gm%) as compared to non- anemic (Hb>10 gm%) (16.67% v/s2.56% respectively), higher in hypoalbuminemia (<3.5g/dL) as compared to patients with albumin (>3.5g/dL) (17.39% v/s2.53% respectively) .Proportion of anastomotic leak was significantly higher in patients with history of radiotherapy as compared to patients without history of radiotherapy (66.67% v/s 4.04% respectively). Comorbidities also contributed to higher rate of anastomotic leak (diabetes mellitus, hypertension, COPD, bronchial asthma, tuberculosis, malignancy and others) (25% v/s0% v/s33.33% v/s0% v/s16.67% v/s20% v/s0% respectively).