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Risk factors for anastomotic leak

A systematic review by Frank McDermott, Des Winter and colleagues in Colorectal Disease identified the following risk factors for anastomotic leak

Read the full paper: Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks

Preoperative: Non-modifiable risk factors Preoperative: Potentially modifiable risk factors Intra-operative risk factors
Male sex
Tumour size > 3 cm
Advanced tumour stage
Metastatic disease
History of radiotherapy
ASA fitness grade > II
Diabetes
Pulmonary disease
Vascular disease
Renal disease
Emergency surgery
Ex-smoker (> 40 pack-years)
Smoking
Obesity (high BMI/waist : hip ratio/visceral fat)
Alcohol excess (> 21 units or 105 g alcohol per week)
Corticosteroids
Biological agents in combination with corticosteroids
Bevacizumab
Malnutrition/hypoalbuminaemia
Intraoperative contamination
Duration of surgery > 4 h
Inotropes
Blood loss
Blood transfusion

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