Colorectal anastomotic leakage can be predicted by abdominal aortic calcification on preoperative CT scans: A pilot study

C Eveno; V Latrasse; É Gayat; R Lo Dico; A Dohan; M Pocard

doi:10.1016/j.jviscsurg.2016.03.007

Colorectal anastomotic leakage can be predicted by abdominal aortic calcification on preoperative CT scans: A pilot study

J Visc Surg. 2016 Aug;153(4):253-7. doi: 10.1016/j.jviscsurg.2016.03.007. Epub 2016 Apr 23.

Authors

C Eveno¹, V Latrasse², É Gayat³, R Lo Dico², A Dohan⁴, M Pocard⁵

Affiliations

¹ Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: [email protected].
² Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
³ Department of intensive care and anaesthesiology, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
⁴ Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Department of abdominal and interventional imaging, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; McGill university health center, department of radiology, McGill university health center, 1650, Cedar avenue, C5 118 Montreal, QC, Canada.
⁵ Surgical oncologic and digestive unit, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Paris-Diderot, Sorbonne Paris Cité, 10, rue de Verdun, 75010 Paris, France; Inserm U965, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.

PMID: 27118170
DOI: 10.1016/j.jviscsurg.2016.03.007

Abstract

Background: There have been no solid data regarding whether patients with aortic calcification (AC) who have undergone colorectal surgery are at increased risk for anastomotic leakage. Our study aim to investigate the impact of AC on anastomotic leakage (AL) and postoperative morbidity after colorectal resection.

Methods: This was a cohort study of 60 patients who were prospectively registered in a database. We evaluated the relationship between an aortic calcification score (ACS), measured on preoperative computed tomography (CT) imaging, and surgical complications in patients undergoing colorectal surgery.

Results: ACS was strongly correlated with mortality rate. All three of the deceased patients were in the ACS-2 group (5%; P=0.021). The rate of AL was positively correlated with ACS; no leakage was found cases of ACS-0, with a rate of 18% in cases of ACS-1 and 44% in cases of ACS-2 (P=0.022). The consequences of AL were more serious according to the grade of ACS.

Discussion: This study suggested that aortic calcification score is correlated with surgical outcomes, particularly anastomosis leakage, after colorectal surgery. These findings could provide useful tools for adapting surgical strategies by delaying colorectal anastomosis in high-risk patients.

Keywords: Anastomotic leakage; Aortic calcification; Colorectal surgery; Mortality.

MeSH terms

Adult
Aged
Aged, 80 and over
Anastomotic Leak / diagnosis
Anastomotic Leak / etiology*
Anastomotic Leak / mortality
Aorta / diagnostic imaging*
Colectomy* / mortality
Colorectal Neoplasms / surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pilot Projects
Preoperative Care*
Rectum / surgery*
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed*
Treatment Outcome
Vascular Calcification / complications*
Vascular Calcification / diagnostic imaging