Factors determining delay in relaparotomy for anastomotic leakage after colorectal resection

Table 1 Patient and treatment characteristics of 36 patients with anastomotic leakage confirmed by relaparotomy

Characteristic	n (%)
Gender
Male	21 (58)
Female	15 (42)
Mean age (range) ( yr)	67 (26-87)
Mean Quetelet index (range)	25 (17-43)
American Society of Anesthesiology score
1	14 (39)
2	16 (44)
3	6 (17)
Comorbidity
Laparotomy in medical history	14 (39)
Diabetes mellitus	6 (17)
Cardiovascular disease	17 (47)
Preoperative radiotherapy	4 (11)
Chronic Obstructive Pulmonary Disease	8 (22)
Type of operation
Ileocolonic resection	5 (14)
Right hemicolectomy	3 (8)
Transverse colonic resection	2 (6)
Left hemicolectomy	1 (3)
Sigmoidal resection	14 (39)
Subtotal colectomy	3 (8)
Anterior resection	7 (19)
Restoring continuity after colostomy	1 (3)

Table 2 Incidence and median postoperative day of first occurrence of simple clinical parameters in 36 patients with anastomotic leakage confirmed at relaparotomy

Variable	Incidence(%)	Median postoperativeday (SD)
Tachycardia (> 100 beats/min)	61	4 (2.6)
Fever (> 38°C)	67	5 (2.4)
Peritoneal reaction	28	6 (3.7)
Leucocytosis (> 10 × 103/mL)	72	6 (2.5)
Adynamic ileus	47	6 (4.6)
Delayed gastric emptying	67	4 (2.0)

SD: standard deviation.

Table 3 Median time intervals between first occurrence of clinical parameters or the attending doctor’s suggestion of anastomotic leakage in the medical record and relaparotomy

Signs/symptomsFirst occurrence of:	Median delay ofrelaparotomy (d)	SD	Range
Tachycardia	2.0	7.2	0-29
Fever	2.8	5.7	0-29
Peritoneal reaction	0.8	2.8	0-8
Leucocytosis	2.0	6.1	0-29
Ileus	1.5	2.4	0-9
Delayed gastric emptying	2.0	5.2	0-25
At least one parameter	3.5	5.7	0-29
At least two parameters	2.5	5.4	0-12
At least three parameters	1.8	5.7	0-8
Doctor’s suggestion of leakage in medical record	1.0	5.1	0-29

Table 4 Risk factors for prolonged delay of relaparotomy because of anastomotic leakage

Variable		n	Mean delay (d)	P
Age (yr)	< 70	19	4.5	0.71
	≥ 70	17	4.9
Sex	Male	21	4.5	0.95
	Female	15	4.9
Body mass index (kg/m2)	< 25	181	4.6	0.29
	≥ 25	14	5.3
Site of anastomosis	Left	25	4.8	0.29
	Right	11	4.3
Radiological examination performed	Yes	21	6.0	0.051
	No	15	2.7
Outcome of radiological examination	FN	9	8.1	0.007
	TP/NP	27	3.5
Weekend included in periodbetween first clinical parameter and relaparotomy	Yes	142	4.2	0.021
	No	18	2.4

FN: false-negative; TP: true-positive; NP: not performed.

¹Four missing values,

²Four patients excluded with delay of more than seven days. Significance of differences in delay between subgroups is determined using the Mann-Whitney test.