Anastomotic Leakage after Right Hemicolectomy – A Retrospective Analysis of Complication Management and Outcome

Schuster S, Aigner C, Raab S and Shamiyeh A

Department of General and Visceral Surgery, Kepler University Clinic (KUK), Med Campus III in Linz, Austria

^*Correspondance to: Stefanie Schuster 

 PDF  Full Text DOI: 10.25107/2474-1647.3696

Abstract

Background: Anastomotic leakage after right hemicolectomy occurs in 6.4% to 8.8%. Risk factors have been described in numerous studies, however, there are rare publications about the complication management. Materials and Methods: This retrospective study is based on data of 641 patients who underwent right hemicolectomy between the years 2010 and 2019 at the Department of General and Visceral Surgery at the Kepler University Clinic (KUK) in Linz, Austria. Patients’ data include information on age, sex, BMI, ASA score, surgical indication, surgical approach, postoperative morbidity and mortality, anastomosis technique, occurrence of leakage, complication management and postoperative hospital stay. In this study, the focus is on the management of 24 cases of anastomotic leakage. Results: Of 641 patients, 41% underwent laparoscopic and 59% open right hemicolectomy. In 3.9% (n=24) of patients with a primary anastomosis, anastomotic leakage occurred. In 12.5% (n=3) the leak was sewn, in 50% (n=12) an anastomosis redo was performed and in 37.5% (n=9) the patient received a terminal ileo-/jejunostomy. 33.3% of the leaking anastomosis were hand-sewn, 66.7% were stapled. With a median postoperative hospital stay of 24 days, patients with over-sewn leaks and anastomosis redo were significantly earlier discharged compared to those with a terminal stoma (55 days; p=0.040*). Conclusion: Regarding the management of postoperative anastomotic leakage after right hemicolectomy, sewing the leakage or redoing the anastomosis is the best choice if suitable. Patients with a terminal stoma had a longer hospital stay. Comparing the leakage management, no difference in the postoperative morbidity and mortality was shown.

Keywords

Anastomotic leakage; Right hemicolectomy; Complication management

Cite the article

Schuster S, Aigner C, Raab S, Shamiyeh A. Anastomotic Leakage after Right Hemicolectomy – A Retrospective Analysis of Complication Management and Outcome. Clin Surg. 2024; 9: 3696..