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anastomoticleak.com

The ANACO study group reported the results of a prospective cohort study of patients undergoing colorectal (right and left sided) resection in 2011-12 in the Annals of Surgery.

Related paper: Risk Factors for Anastomotic Leak After Colon Resection for Cancer

In total data was collected on 3,193 patients across 52 Spanish hospitals. The overall anastomotic leak rate was 8.7%. Patients who experienced anastomotic leak experienced a much higher mortality than patients who did not have a leak (15.2% versus 1.9%).

 

The group created a risk stratifier to predict the risk of anastomotic leak. This included:

  • Use of oral anticoagulants (excluding aspirin)
  • Obesity (body mass index >30)
  • Total serum protein
  • Sex
  • Intra-operative complication
  • Total number of hospital beds

 

The risk stratifier has been externally validated by an Sammour and colleagues in Australia, who found that in a prospective cohort of 83 patients anastomoticleak.com was highly predictive of leak (area under the curve [AUC] 0.84). In contrast surgeons’ predictions were worse than guessing (AUC 0.40)!

Related paper: A simple web-based risk calculator (www.anastomoticleak.com) is superior to the surgeon’s estimate of anastomotic leak after colon cancer resection

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