Preoperative risk factors for anastomotic leakage after resection for colorectal cancer: a systematic review and meta-analysis.
Colorectal Dis
; 16(9): 662-71, 2014 Sep.
Article
in En
| MEDLINE
| ID: mdl-24655784
ABSTRACT
AIM:
Colorectal anastomotic leakage is a serious complication. Despite extensive research, no consensus on the most important preoperative risk factors exists. The aim of this systematic review and meta-analysis was to evaluate risk factors for anastomotic leakage in patients operated with colorectal resection.METHOD:
The databases MEDLINE, Embase and CINAHL were searched for prospective observational studies on preoperative risk factors for anastomotic leakage. Meta-analyses were performed on outcomes based on odds ratios (OR) from multivariate regression analyses. The Newcastle-Ottawa scale was used for bias assessment within studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels.RESULTS:
This review included 23 studies evaluating 110,272 patients undergoing colorectal resection for cancer. The meta-analyses found that a low rectal anastomosis [OR = 3.26 (95% CI 2.31-4.62)], male gender [OR = 1.48 (95% CI 1.37-1.60)] and preoperative radiotherapy [OR = 1.65 (95% CI 1.06-2.56)] may be risk factors for anastomotic leakage. Primarily as a result of observational design, the quality of evidence was regarded as moderate or low for these risk factors according to the GRADE approach.CONCLUSION:
Based on the best available evidence, important preoperative risk factors for colorectal anastomotic leakage have been identified. Knowledge on risk factors may influence treatment and procedure-related decisions, and possibly reduce the leakage rate.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
Preoperative Period
/
Anastomotic Leak
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Colorectal Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2014
Document type:
Article
Affiliation country: