Aetiology of disruption of intestinal anastomoses

Abstract

Various factors have been cited in the aetiology of disruption of intestinal anastomoses but their relative clinical importance is uncertain. A retrospective study was made of 204 patients treated by resection and standard end-to-end anastomosis of the intestine. Clinical evidence of anastomotic dehiscence occurred in 14 per cent of cases and the incidence of dehiscence was significantly increased in cases where faecal loading of the bowel obtained and after operations involving low anterior resection of the rectum or surgery for fixed tumours. The presence of a defunctioning colostomy did not remove the threat of anastomotic complications. A significant reduction in preoperative plasma proteins was found in patients who developed anastomotic dehiscence and the incidence of disruption was highest in patients over the age of 60 years.