Abstract

Bowel anastomosis is one of the most commonly performed surgical procedures when bowel resections are carried out for gastrointestinal tract pathology. Previous studies at Bugando Medical Centre showed that anastomotic leakage is one of the most dreaded complications and is associated with increased morbidity, mortality and prolonged hospital stay. This study aimed to give evidence on the prevalence and factors associated with anastomotic leakage among patients undergoing bowel resection and anastomosis at Bugando Medical Centre (BMC) and Sekou Toure Regional Referral Hospital (SRRH). A descriptive cross-sectional analytical study was used involving patients undergoing bowel resection and anastomosis at Bugando Medical Centre and Sekotoure Regional Referral Hospital over four months from March 2017 to June 2017 inclusive. Eight out of 144 patients (5.6%) developed anastomotic leakage. The common indication for surgery was sigmoid volvulus, the commonly performed anastomosis was ileo-ileo end to end, and double layer continuous anastomotic suture was the common method of anastomosis Anaemia (0.012), presence of premorbid illnesses (p=0.003), American Association for Anesthesia (ASA) greater than II (p=0.001), intraoperative contamination/sepsis (p< 0.001), low-ranked operator (p=0.046), prolonged duration of operation (p=0.001), and delayed passage of stool and flatus (p=0.001) were found to be variables associated with anastomotic leakage among study participants. Anastomotic leakage in our setting occurs in approximately 5.6% of patients operated on. Several factors such as high American Society for Anesthesiologists above III, premorbid conditions such as uncontrolled Diabetes Mellitus, intraoperative contamination/sepsis, low-ranked operator, prolonged duration of operation above 3 hours and prolonged ileus were among factors that the present study found to be associated with a high risk of anastomotic leakage. Therefore, these factors should be carefully considered when planning for patients for surgical interventions to reduce the potential subsequent anastomotic leakage.

Keywords: Bowel anastomosis, gastrointestinal tract pathology, anastomotic leakage, sigmoid volvulus, premorbid illnesses

Prevalence and factors associated with anastomotic leakage among patients undergoing bowel resection and anastomosis

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Authors

DR OSMUND J DYEGURA
DR OSMUND J DYEGURA is a research scholar at the Catholic University, Health and Allied Sciences, Medicine and Surgery, Bugando, Mwanza, Tanzania,33830

NSAGHURWE MAGOHE
NSAGHURWE MAGOHE is a research scholar at the Mwalimu Nyerere Memorial Hospital, Health Statistical Department, Musoma Municipal, Tanzania, 31115

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How to Cite

Dyegura D. J. and Magohe N. (2023): Prevalence and factors associated with anastomotic leakage among patients undergoing bowel resection and anastomosis. 4(3), 35-50. https://doi.org/10.47721/ARJST20230403014