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 |