Assessment of Various Prognostic Factors of Intestinal Anastomotic Leakage

Abstract

Objectives: To determine the various prognostic factors of intestinal anastomosis leakage at tertiary care Hospital Material and Methods: This prospective cross-sectional study was conducted in Surgical Units of Liaquat University Hospital Jamshoro/Hyderabad. A total 100 patients were included those underwent intestinal anastomosis. After taking detailed history and clinical examination, in the patients’ relevant investigations i.e. Blood CP, X-ray abdomen, Methylene Blue Test (to confirm leaks) and ultrasound of the abdomen. If they remain free of any complication, they were discharged. After collection of data, the analyses were done using Statistical Package for Social Science (SPSS) program version 26.0 Results: Mean age of the patients was recorded as 51.5+3.5 years and males were found in the majority (76.6%). In the clinical presentation, abdominal pain was the most common (63.6%). Typhoid 75(25.0%) was the most common diagnosis. The pathological sites were found as Ileocolic 180(60.0%). Poor nutritional status was in 60.0% cases. Anaemia was 40%, diabetes 20%, and hypertension 10%. A high steroid dose history was in 10% cases and 6.6% had a history of chemotherapy. Ischemia of the intestine at the suture line was seen in 6%, local sepsis was 20%, obstruction distal to the anastomosis was 6.6%, postoperative early adhesions was 6.6%. Conclusion: Male gender, poor nutritional status, diabetes, anemia, presence of local sepsis, chemotherapy and high dose steroid were observed highly prevalent and suspected as factors of anastomosis leakage. Furthermore, many efforts need to be made to reduce the mortality and morbidity rates associated with anastomotic leaks.