ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2020
Development of a Risk Score to Predict Anastomotic Leak After Left-Sided Colectomy: Which Patients Warrant Diversion?
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Score prediction of anastomotic leak in colorectal surgery: a systematic review.Surgical endoscopy · 2024Pooled it
- Systematic review of preoperative and intraoperative colorectal Anastomotic Leak Prediction Scores (ALPS).BMJ open · 2023Pooled it
- Robotic vs. Laparoscopic Stapling in Robotic Total Mesorectal Excision: A Prospective Cohort Study.Cureus · 2026Article
- Safety and Feasibility Colorectal Anastomosis Protocol Implementation: Results from the CASPI Single-Arm Pilot Study.Cancers · 2026Article
- Evaluation of the Diagnostic and Predictive Significance of Postoperative C-Reactive Protein to Transferrin or Albumin Ratio in Identifying Septic Events Following Major Abdominal Surgery.Journal of clinical medicine · 2025Article
- Automated Identification of Postoperative Infections to Allow Prediction and Surveillance Based on Electronic Health Record Data: Scoping Review.JMIR medical informatics · 2024Article
- Stoma associated complications after diverting loop ileostomy, end ileostomy or split stoma formation after right sided colectomy-a retrospective cohort study (StoComSplit Analysis).Techniques in coloproctology · 2024Article
- Smoking Cessation for Preoperative Optimization.Clinics in colon and rectal surgery · 2023Review
- Development and Validation of Machine Learning Models to Predict Readmission After Colorectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Differential Performance of Machine Learning Models in Prediction of Procedure-Specific Outcomes.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Defining Anastomotic Leak and the Clinical Relevance of Leaks.Clinics in colon and rectal surgery · 2021Review
- Anastomotic leak in patients with acute complicated diverticulitis undergoing primary anastomosis: risk factors and the role of diverting loop ileostomy.International journal of colorectal disease · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAnastomotic leak is a feared complication after left-sided colectomy, but its risk can potentially be reduced with the use of a diverting ostomy. However, an ostomy has its own associated negative sequelae; therefore, it is critical to appropriately identify patients to divert. This is difficult in practice since many risk factors for anastomotic leak exist and outside factors bias this decision. We aimed to develop and validate a risk score to predict an individual's risk of anastomotic leak and aid in the decision.
methodsThe American College of Surgeons National Surgical Quality Improvement Program Colectomy Targeted PUF was queried from 2012 to 2016 for patients undergoing elective left-sided resection for malignancy, benign neoplasm, or diverticular disease. Multivariable logistic regression identified predictors of anastomotic leak in non-diverted patients, and a risk score was developed and validated.
results38,475 patients underwent resection with an overall anastomotic leak rate of 3%. Independent risk factors for anastomotic leak included younger age, male sex, tobacco use, and omission of combined bowel preparation. A risk score incorporating independent predictors demonstrated excellent calibration. There was strong visual correspondence between predicted and observed anastomotic leak rates. 3960 patients underwent resection with diversion, yet over half of these patients had a predicted leak rate of less than 4%.
conclusionA novel risk score can be used to stratify patients according to anastomotic leak risk after elective left-sided resection. Intraoperative calculation of scores for patients can help guide surgical decision-making in both diverting the highest risk patients and avoiding diversion in low-risk patients.
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