Anastomotic Leak after Colorectal Surgery. Our Experience in three Years.
AJTES Vol 3, No 2, July 2019.
Full Text PDF


Anastomotic Leak
Colorectal Surgery
intestinal resection
septic shock

How to Cite

Haxhirexha, K., Dogjani, A., Zylbehari, L., Baftiu, N., & Dika – Haxhirexha, F. (2019). Anastomotic Leak after Colorectal Surgery. Our Experience in three Years. Albanian Journal of Trauma and Emergency Surgery, 3(2), 403-408.


Background: One of the most severe complication after intestinal resection, often with catastrophic consequence for the patient is leakage from the anastomosis. The severity of complications after anastomotic leak may range from a small localized peritonitis or abscess formation without sepsis, to a development of a four quadrant peritonitis with septic shock. Until now despite the seriousness of this complications, the cause of anastomotic leakage are not yet definitively clear. Aim: The aim of this study is to submit our experience in treatment of patients with anastomotic leakage after intestinal resection and their outcome.

Materials and Methods: The study included 63 patients with colorectal cancer operated in the Department of Surgery at the Clinical Hospital of Tetova. In all patients intestinal resection with end to end anastomosis was performed.

Conclusions: Anastomotic leak after large bowel resection is a very serious complication with a great impact on patient’s morbidity and mortality. 
Multiple risk factors are associated with occurrence of this complication whereas the more suspected are: preoperative anaemia, hypoalbuminemia, emergent surgery without adequate preparation of patient, intraoperative blood loss and blood transfusion during surgery etc. Early detection of AL is very important and helpful to improve the outcome of patients and to minimize postoperative rate of morbidity and mortality.

Keywords: anastomotic leaks, colorectal surgery, risk factors
Full Text PDF


Bruce J, Krukowski ZH, Al-Khairy G et al (2001). Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg. 88(9):1157- 68

Bieleki K and Gajda A (1999). The causes and prevention of anastomotic leak after colorectal surgery: Klinickaonkology; 25-30

Chambers WM and Mortensen NJ (2004). Postoperative leakage and abscess formation after colorectal surgery. Best Pract Res Clin Gastroenterol; 18 (5): 865-80.

Jung SH, Yuc S, Choip W et al (2008). Risk factors and oncolgic impact of anastomtic leakage after rectal cancer surgery. Dis colon rectum; 51: 902- 908.

Daams F, Luyer M and Lange JF (2013). Colorectal anastomotic leakage: aspects of prevention, detection and treatment. World J Gastroenterol; 19(15):2293-7

Wille-Jørgensen P, Guenaga KF, Matos D et al (2005). Pre-operative mechanical bowel cleansing or not? an updated meta-analysis. Colorectal Dis. 7(4):304-10.

Kiran RP, Delaney CP, Senagore AJ et al (2004). Operative blood loss and use of blood products after laparoscopic and conventional open colorectal operations. Arch Surg. 139(1):39-42

T, Watanabe T, Kishimoto J, Nagawa H. Risk factors for anastomotic leakage for colorectal cancer: Results of prospective surveillance. J Am Coll Surg. 2006; 202: 439–44

Iancu C, Mocan LC, Todea-Iancu D, Mocan T, Acalovschi I, Ionescu D, et al. Host-related predictive factors for anastomotic leakage following large bowel resections for colorectal cancer. J Gastrointestin Liver Dis. 2008; 17: 299–303.

McDermott FD, Heeney A, Kelly ME, Steele RJ, Carlson GL, Winter DC. Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks. Br J Surg 2015;102(5):462-79. Doi: 10.1002/bjs.9697.

Bakker IS, Grossmann I, Henneman D, Havenga K, Wiggers T. Risk factors for anastomotic leakage and leak – related mortality after colonic cancer surgery in a nationwide audit. Br J Surg 2014; 101(4):424-32. Doi: 10.1002ébsj.9395.

Boccola MA, Buettner PG, Rozen WM, Siu SK, Stevenson AR, Stitz R, Ho YH. Risk factors and outcomes for anastomotic leakage in colorectal surgery: a single-institution analysis of 1576 patients. World J Surg 2011;35(1):186-95. Doi: 10.1007/s00268-010-0831-7.

Frasson M, Flor-Lorente B, Rodriguez JL, Granero-Castro P, Hervas D, Alvarez Rico MA, et al. Risk Factors for Anastomotic Leak After Colon Resection for Cancer : Multivariate Analysis and Nomogram From a Multicentric, Prospective, National Study With 3193 Patients. Ann Surg 2015;262(2):321-30. Doi: 10.1097/SLA.0000000000000973

Parthasarathy M, Greensmith M, Bowers D, Groot – Wassink T. Risk factors for anastomotic leakage after colorectal resection: a retrospective analysis of 17 518 patients. Colorectal Dis 2017; 19(3):288- 298. Doi: 10.1111/codi.13476

Kirchhoff P, Clavien PA and Hahnloser D (2010).Complications in colorectal surgery: risk factors and preventive strategies. Patient Saf Surg.4(1):5.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.