Anthony Dinallo, MD1, Danielle Craigg, MD1, Megan Navarro2, Abdelrahman Attili, MD3, Timothy Bourdeau1, Janelle Spence1, Haane Massarotti, MD1, Allen Chudzinski, MD1. 1Florida Hospital Tampa, 2University of South Florida, 3University of Central Florida
Purpose: An anastomotic leak is a devastating complication for both the patient and the surgeon, leading to an increased length of stay, higher local recurrence, greater cost and increased mortality. Leak rates in colorectal surgery range from 2.4% to 19%. The purpose of this study is to compare a single institution’s anastomotic leak rate with national averages provided by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP).
Methods: Over a two year period (March 2016 – March 2018) with IRB approval, 163 patients were reviewed who underwent colorectal resections and primary anastomoses. Anastomotic leak was the primary outcome measured. Each complication was also evaluated including pneumonia, urinary tract infection, and venous thromboembolism. Data is expressed as mean in percentages and length of stay as median percentage (mean ± SD) where appropriate.
Results: Of the 163 patients who underwent colorectal resections, three patients experienced an anastomotic dehiscence (1.8%). Two of these patients had robotic assisted procedures: one total abdominal colectomy and one ileocecectomy. The other patient underwent an open right colectomy. This leak rate of 1.8% was less than the NSQIP rate of 2.7%. Other outcomes such as length of stay, death, readmission within 30 days, and complications including: pneumonia, cardiac anomalies, UTI’s, DVT’s, surgical site infections, ileus, and renal complications, were evaluated and compared to NSQIP (table 1). The actual outcome for surgical site infection (SSI) of 2.4% was statistically different from NSQIP outcome of 7.4% (p=0.029). All other predicted and actual outcomes were not statistically different from NSQIP outcomes.
Conclusion: This study reveals a single institution’s anastomotic leak rate to be less than the national average provided by NSQIP. Given the devastating impact of anastomotic leaks, it is important to be recognized as a marker of surgical quality when evaluating surgical performance.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95417
Program Number: P353
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster