Anastomotic Leakage Risk Factors in War-affected Syria
- Conditions
- Anastomotic Leakage in Colon SurgeryAnastomotic Leak RectumAnastomotic Leak Large Intestine
- Registration Number
- NCT07092631
- Lead Sponsor
- Elie Bitar
- Brief Summary
The goal of this observational study is to know the most important risk factors for anastomotic leakage in colorectal cancer patients.
The main questions it aims to answer are:
how to decrease the incidence of leakage? how to improve the operations outcome?
Participants answered a questionnaire which gathered a wide range of information including demographic characteristics, lifestyle habits, medical history, tumor characteristics, and specific surgical details.
- Detailed Description
this is a retrospective cohort study conducted at the General Surgery Department of Damascus Hospital from 2016 to February 2024.
Due to the prolonged conflict and economic sanctions, the hospital operates under considerable resource constraints, we aimed to identify the risk factors associated with anastomotic leakage in patients undergoing resection of the sigmoid colon or rectum for colorectal cancer.
Initially, 137 patients were identified for inclusion in the study. we included all patients who underwent procedures for tumor-related indications, excluding those with other medical conditions and emergency cases. This resulted in the final cohort of 100 patients.
the vast majority of procedures (98%) were performed using an open approach, with laparoscopic procedures accounting for only 2% of the cases.
Unlike studies from high-income countries that primarily analyzed laparoscopic or robotic colorectal procedures, our findings reflect outcomes in open surgery performed in a conflict zone under limited-resource conditions.
The incidence of leakage in this study was found to be 15%, which falls within the global range of 3-18%.
The female sex was dominant, unlike the rest of the studies, which showed that the male sex has a greater possibility of leakage after performing anastomosis after colorectal resection.
Notably, multiple studies have established a strong correlation between hypoalbuminemia-especially levels below 3.5 g/dL-and an increased risk of anastomotic leakage, underscoring the importance of albumin assessment in peri-operative and critical care settings. As when compared to other studies, we found the Albumin has strong evidence to be a risk factor in Anastomotic leakage. On the other hand, our study showed that a hemoglobin level \< 10 is a major risk factor for anastomotic leakage, as has been proven in other studies.
A limitation of this study was the lack of a laparoscopic comparison group, which restricts broader generalizability. However, given the resource-constrained environment of our institution, these findings remain highly relevant to similar settings worldwide, including conflict-affected or low-income regions.
the study led to updated surgical protocols at Damascus Hospital, demonstrating how localized research can directly influence practice and improve patient outcomes, even under the constraints of war and economic hardships.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- Patients who underwent colorectal cancer surgery for tumor-related indications.
- Emergency cases
- Non-tumor related colorectal surgeries
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Incidence of Anastomotic Leakage Within 30 Days After Surgery Within 30 days post-surgery The proportion of colorectal cancer patients who developed anastomotic leakage within 30 days following colorectal resection.
Measure Type: Percentage Unit of Measure: % of patients with anastomotic leakage How Measured: Clinical and/or radiological diagnosis recorded in the patient chart
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Syrian Private University
🇸🇾Damascus, Syrian Arab Republic
Syrian Private University🇸🇾Damascus, Syrian Arab Republic