Development of a warning score for early detection of colorectal anastomotic leakage: Hype or hope?

doi:10.4240/wjgs.v14.i11.1297

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Nov 27, 2022 (publication date) through Feb 15, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Nov 27, 2022; 14(11): 1297-1309
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1297

Table 2 Patient demographics and clinical and operative characteristics

Characteristic	Group 1, n = 277	Group 2, n = 94	Group 3, n = 25	P value
Age, mean ± SD	68.8 ± 11.3	72.2 ± 14.5	73.6 ± 13.6	0.02^a
Sex, n (%)				0.505
Male	161 (58.1)	59 (62.7)	17 (68.0)
Female	116 (41.9)	35 (37.3)	8 (32.0)
BMI, mean ± SD	26.8 ± 3.99	26.3 ± 4.05	26.0 ± 3.97	0.33
CCI, mean ± SD	5.12 ± 1.83	5.55 ± 2.38	6.04 ± 2.15	0.03^a
ASA score, n (%)				0.018^a
I–II	187 (67.5)	47 (50.0)	13 (45.8)
III–IV	90 (32.5)	47 (50.0)	12 (54.2)
Type of surgery, n (%)				0.071
Elective	238 (86.0)	72 (76.6)	19 (75.0)
Urgent	39 (14.0)	22 (23.4)	6 (25.0)
Surgical approach, n (%)				< 0.001^a
Open	25 (9.0)	15 (16.0)	2 (8.0)
Laparoscopic	238 (86.0)	72 (77.0)	15 (60.0)
Conversion	14 (5.0)	7 (7.4)	8 (32.0)
Procedure, n (%)				0.739
Right colectomy¹	138 (49.8)	47 (50.0)	11 (44.0)
Left colectomy	17 (6.1)	7 (7.4)	1 (4.0)
Sigmoid/RS resection	55 (19.8)	15 (15.9)	4 (16.0)
Low anterior resection	48 (17.3)	16 (17.0)	8 (32.0)
Other	19 (6.8)	9 (9.6)	1 (4.0)
Level of anastomosis, n (%)				0.66
Ileocolic	150 (54.1)	50 (53.2)	11 (44.0)
Colocolic	23 (8.3)	5 (5.3)	1 (4.0)
≥ 6 cm from AV	67 (24.2)	25 (26.6)	10 (40.0)
< 6 cm from AV	37 (13.4)	14 (14.9)	3 (12.0)
Covering stoma, n (%)	23 (8.3)	8 (8.51)	2 (8.0)	0.99
Blood loss in mL, mean ± SD	51.6 ± 36.6	58.8 ± 47.7	104.0 ± 191.1	< 0.001^a
Intraoperative complications, n (%)	3 (1.1)	5 (5.3)	4 (16.0)	< 0.001^a
Operative time in min, mean ± SD	141.9 (48.3)	146.2 (50.0)	172.8 (57.2)	0.011^a
LOHS in d				< 0.001^a
mean ± SD	7.4 ± 2.1	14.3 ± 7.4	24.0 ± 14.0
Median	7	13	21
90-d mortality, n (%)	0 (0)	0 (0)	3 (12.0)	< 0.001^a

^aP < 0.05.

¹Included ileocecal resection/extended right-sided colectomy.

Group 1: No complications; Group 2: Complications not related to colorectal anastomotic leakage; Group 3: Colorectal anastomotic leakage. ASA: American Society of Anesthesiologists; AV: Anal verge; BMI: Body mass index; CCI: Charlson Classification Index; LOHS: Length of hospital stay; RS: Rectosigmoid; SD: Standard deviation.

Citation: Rama NJG, Lourenço Ó, Motta Lima PC, Guarino MPS, Parente D, Castro R, Bento A, Rocha A, Castro-Poças F, Pimentel J. Development of a warning score for early detection of colorectal anastomotic leakage: Hype or hope? World J Gastrointest Surg 2022; 14(11): 1297-1309
URL: https://www.wjgnet.com/1948-9366/full/v14/i11/1297.htm
DOI: https://dx.doi.org/10.4240/wjgs.v14.i11.1297