Risk factors for colorectal anastomotic dehiscence in colorrectal cancer
Sharon G. Jarquín-Vásquez 1 
, Carlos A. López-Bernal 2 , Álvaro J. Montiel-Jarquín 3 , Arturo García-Galicia 4 , Nancy R. Bertado-Ramírez 4 , Angélica Porras-Juárez 5 , José A. Parra-Salazar 6 , Sandra Maldonado-Castañeda 7 , Jorge Garza-Sánchez 8
1 Departamento de Cirugía General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Pue., México; 2 Department of Coloproctology. High Specialty Medical Unit Hospital de Especialidades, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, IMSS. Puebla de Zaragoza, Puebla, Mexico; 3 Dirección de Educación e Investigación en Salud, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 4 Dirección de Educación e Investigación en Salud. Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Pue., México; 5 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 6 Dirección General, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Puebla, México; 7 Modelo de Atención a la Salud para el Bienestar, Instituto Mexicano del Seguro Social Bienestar. Puebla, Pue., México; 8 Departamento de Cirugía Colorrectal, Hospital Ángeles de Puebla. Puebla, Pue., México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: alvaro.montielj@imss.gob.mx
Abstract
Background: Surgery is essential in the management of colorectal cancer. This study analyzes risk factors for anastomotic leaks in patients with colon resection and anastomosis for colorectal cancer.
Objective: To present the risk factors for colorectal anastomosis dehiscence.
Material and methods: Descriptive, and cross-sectional study, from January 2022 to December 2023. Age, sex, body mass index (BMI), duration of surgery, leak and anatomical site of anastomosis, intraoperative transfusions, comorbidities, days of hospital stay, intestinal preparation, drainage, clinical stage, CONUT Index, total parenteral nutrition (TPN), protective or prophylactic stoma, type of anastomosis, systemic chemotherapy treatment and/or neoadjuvant or adjuvant radiotherapy, and total bleeding were evaluated. Descriptive statistics and Fisher’s test were used.
Results: Mean age 58.75 years, women 52.8%, BMI ≥ 25 52.8%, surgeries ≥ 180 minutes 66.7%, no transfusions 86.1%, hospital stay ≤ 10 days 73%. The anastomotic site was divided between colon (50%) and rectum (50%). No comorbidities 61.1%, bowel preparation 94.4%, use of drains 80.6%, stages III-IV 51.4%, mild to severe CONUT risk 79.2%, no TPN 73.6% or protective stoma 83.3%. There were mechanical anastomoses (83.3%), systemic management (84.7%), and bleeding < 1,000 ml (97.2%). Anastomotic leak in 25% of the patients.
Conclusions: The risk factors were intestinal preparation, drainage, and systemic treatment.
