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<p>This study aimed to analyze the incidence and risk factors of acute anastomotic leak (AL) in patients with colorectal cancer (CRC) during and after the COVID-19 pandemic. Active COVID-19 was evaluated as a risk factor of acute AL. A retrospective multicenter analysis was performed on 390 patients with CRC between April 2020 and October 2024. Patients were divided into acute AL (<i>n</i> = 27) and no acute AL (no AL) (<i>n</i> = 363) groups. In the acute AL group, there were 24 (88.8%) men and three (11.2%) women, with a median age of 63 (65–67) years. Twenty-seven patients in both groups had a previous COVID-19 infection and 15 patients (55.5%) who complained of COVID-19 had AL. The incidence of clinical AL was 6.9% (27/390), of which 11.1% (3/27) and 88.9% (24/27) were grade B and C, respectively. 24/27 (88.9%) had free AL with peritonitis requiring surgical re-intervention. Multivariate analysis showed that active COVID-19 infection (OR = 176, 95% CI 14.27–2172.57, <i>p</i> &lt; 0.001) and serum albumin level &lt; 3&#xa0;g/dl (OR = 16.249, 95% CI 1.033–255.544, <i>p</i> = 0.04) were associated risk predictors of AL, while the laparoscopic approach (OR = 0.032, 95% CI 0.002–0.434, <i>p</i> = 0.01) and splenic flexure mobilization (OR = 0.022, 95% CI 0.003–4.844, <i>p</i> = 0.02) were protective. The incidence of AL after CRC surgery did not increase during or after the COVID-19 pandemic. Active COVID-19 and serum albumin levels &lt; 3&#xa0;g/dl were associated risk factors for AL, while the laparoscopic approach and splenic flexure mobilization were protective.</p>

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Updates in surgery for colorectal cancer: incidence and risk factors for acute anastomotic leak—a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Tamer A. A. M. Habeeb,
  • Abdulzahra Hussain,
  • Massimo Chiaretti,
  • Igor A. Kryvoruchko,
  • Aristotelis Kechagias,
  • Abd Al-Kareem Elias,
  • Abdelmonem A. M. Adsam,
  • Mohamed A. Gadallah,
  • Saad Mohamed Ali Ahmed,
  • Ahmed khyrallh,
  • Mohammed H. Alsayed,
  • Esmail Tharwat Kamel Awad,
  • Emad A. Ibrahim,
  • Mohamed Fathy Labib,
  • Sobhy Rezk Ahmed Teama,
  • Mohamed Sobhy Shaaban,
  • Mohammed Hassan Elshafey,
  • Abdelhafez Seleem,
  • Amr Radwan,
  • Hamada Rashad Mohamed Abdelkader,
  • Ahmed Fayez Othman,
  • Nasreldin Mohammed Algalaly,
  • Mostafa Mahmoud Salama Mostafa,
  • Mohammed Abbas Abdou Abouelseoud,
  • Mohamed Ibrahim Abo Alsaad,
  • Abouelatta KH. Ali,
  • Hamdi Elbelkasi,
  • Mahmoud Ali Abou Zaid,
  • Basma Ahmed Mohamed,
  • Islam Mohamed Ibrahim,
  • Ahmed Gamal Eldin Metwally,
  • Mahmoud El Azawy,
  • Amr khalil,
  • Sameh Tolba Abu-Elela,
  • Ahmed Kamal El Taher,
  • Mahmoud Abdou Yassin,
  • Mohamed Lotfy,
  • Bassam Mousa,
  • Baher Atef,
  • Mohamed Elnemr,
  • Ahmed Mesbah Abdelaziz,
  • Tamer Wasefy,
  • Mohamed Ibrahim Mansour,
  • Abdelrahman Mohamed Hasanin Nawar

摘要

This study aimed to analyze the incidence and risk factors of acute anastomotic leak (AL) in patients with colorectal cancer (CRC) during and after the COVID-19 pandemic. Active COVID-19 was evaluated as a risk factor of acute AL. A retrospective multicenter analysis was performed on 390 patients with CRC between April 2020 and October 2024. Patients were divided into acute AL (n = 27) and no acute AL (no AL) (n = 363) groups. In the acute AL group, there were 24 (88.8%) men and three (11.2%) women, with a median age of 63 (65–67) years. Twenty-seven patients in both groups had a previous COVID-19 infection and 15 patients (55.5%) who complained of COVID-19 had AL. The incidence of clinical AL was 6.9% (27/390), of which 11.1% (3/27) and 88.9% (24/27) were grade B and C, respectively. 24/27 (88.9%) had free AL with peritonitis requiring surgical re-intervention. Multivariate analysis showed that active COVID-19 infection (OR = 176, 95% CI 14.27–2172.57, p < 0.001) and serum albumin level < 3 g/dl (OR = 16.249, 95% CI 1.033–255.544, p = 0.04) were associated risk predictors of AL, while the laparoscopic approach (OR = 0.032, 95% CI 0.002–0.434, p = 0.01) and splenic flexure mobilization (OR = 0.022, 95% CI 0.003–4.844, p = 0.02) were protective. The incidence of AL after CRC surgery did not increase during or after the COVID-19 pandemic. Active COVID-19 and serum albumin levels < 3 g/dl were associated risk factors for AL, while the laparoscopic approach and splenic flexure mobilization were protective.