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Gastroenterology Research and Practice
Volume 2016 (2016), Article ID 1563037, 5 pages
http://dx.doi.org/10.1155/2016/1563037
Research Article

Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery

1Department of General, Visceral, Vascular, and Thoracic Surgery, Hospital of Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
2Department of Visceral and Transplant Surgery, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
3Institute of Pathology, Mühlemattstrasse 11, 4410 Liestal, Switzerland
4Department of Gastroenterology, Hirslanden-Clinic Beau-Site, Schänzlihalde 1, 3000 Bern-25, 3013 Bern, Switzerland
5Department of Surgery, Hirslanden-Clinic Beau-Site, Schänzlihalde 1, 3000 Bern-25, 3013 Bern, Switzerland

Received 7 September 2016; Revised 27 November 2016; Accepted 8 December 2016

Academic Editor: Martin Hubner

Copyright © 2016 Samuel Andreas Käser et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Liver cirrhosis associated with high perioperative morbidity/mortality. This retrospective study determines whether liver cirrhosis represents a risk factor for anastomotic leakage after colonic anastomosis or not. Methods. Based on a prospective database with all consecutive colorectal resections performed at the authors’ institution from 07/2002 to 07/2012 () all colonic and rectal anastomoses were identified (). A temporary loop ileostomy was constructed in 257 cases (13.7%) either due to Mannheimer Peritonitis-Index > 29 or rectal anastomosis below 6 cm from the anal verge. More than one-third of the patients () had postoperative contrast enema, either at the occasion of another study or prior to closure of ileostomy. The presence of liver cirrhosis and the development of anastomotic leakage were assessed by chart review. Results. The overall anastomotic leakage rate was 2.7% (50/1875). In patients with cirrhosis/severe fibrosis, the anastomotic leakage rate was 12.5% (3/24), while it was only 2.5% (47/1851) in those without (). The difference remained statistically significant after correction for confounding factors by multivariate analysis. Conclusion. Patients with liver cirrhosis/severe fibrosis have an increased risk of leakage after colonic anastomosis.