A PROSPECTIVE STUDY TO EVALUATE MORTALITY, MORBIDITY, AND RISK FACTORS IN INTESTINAL RESECTION AND ANASTOMOSIS PATIENTS AT A TERTIARY CARE CENTRE OF WESTERN RAJASTHAN
Main Article Content
Keywords
Anastomotic leak, Dehiscence, Intestinal anastomosis, Risk factors, Diabetes mellitus, Morbidity
Abstract
Morbidity and mortality following intestinal anastomosis are often attributed to anastomotic dehiscence. The reported incidence of anastomotic leaks ranges from 0.5% to 30%, with an associated mortality rate of 10%–15%. Multiple risk factors have been implicated. This study aimed to evaluate the morbidity, mortality and risk factors contributing to anastomotic dehiscence in patients undergoing intestinal resection and anastomosis.
Methods: A prospective observational study was conducted from March 2018 to February 2021 in the Department of General Surgery at Dr. S.N. Medical College, Jodhpur, Rajasthan. All patients undergoing hand-sewn gastrointestinal anastomosis, including both elective and emergency procedures, were included. A total of 43 patients were evaluated for morbidity, mortality, and associated risk factors.
Results: Anastomotic leaks were observed in 3 out of 43 patients (6.97%). The overall mortality rate was 11.63%. Increasing age was not significantly associated with leakage (p = 0.40), although a 20% leak rate was noted in the 51–60 years age group. Gender distribution showed no significant association. Among the evaluated risk factors, only diabetes mellitus was significantly associated with anastomotic dehiscence (p = 0.019). Other factors such as elevated serum creatinine, hyperbilirubinemia, and emergency surgery were not statistically significant.
Conclusions: Diabetes mellitus emerged as the only significant risk factor associated with anastomotic leaks. Other traditionally recognized risk factors were not statistically significant in this study. Optimized perioperative glycaemic control may help reduce anastomotic dehiscence and improve patient outcomes
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Lakhan Kumar Purohit
Assistant Professor, Department of General Surgery, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
Abdul Wasim Khan
Assistant Professor, Department of General Surgery, Pandit Deendayal Upadhyay Medical College Churu, Rajasthan, India
Ram Dayal
Associate Professor, Department of General Surgery, Dr. S.N. Medical College, Jodhpur, Rajasthan, India
Prahlad Ram Kalwan
Associate Professor, Department of General Surgery, Geetanjali Medical College and Hospital Udaipur, Rajasthan, India