Evaluation of Prognostic Factors in Outcome of Bowel Anastomosis: A Hospital Based Study

Background: Bowel anastomosis is the surgical procedure done in order to establish communication between two formerly distant portions of the bowel. This surgical procedure restores bowel continuity after the removal of a pathological condition affecting the intestines. A dangerous complication of bowel anastomosis is anastomotic leak causing peritonitis, which is related with a high morbidity and mortality. Aims of this study was to recognize the risk factors for anastomotic leak and study the rate of early complications and mortality of intestinal anastomosis. Methods: This prospective hospital based study was conducted at Department of General Surgery, SKMCH, Muzaffarpur, and Bihar from March 2024 to August 2024. A total of 50 patients undergoing resection and anastomosis for different diseases were studied. Information was collected from detailed history, clinical examination and investigations (both hematological and radiological investigations) on the patients. Results: In present study, there were 30 male patients (60%) and 20(40%) female patients. The age of the patients in this study ranged from 18 to 85 years. 43(86%) patients underwent anastomosis in the emergency setting and 7(14%) underwent anastomosis in elective setting. In this study out of 50 total patients, 46 patients (92%) underwent end to end anastomosis, 2 patients (4%) underwent end to side anastomosis and 2 patients (4%) underwent side to side anastomosis. The risk factors which are known to influence the outcome of bowel anastomosis particularly the occurrence of the anastomotic leak were observed and recorded including age, anaemia, hypoalbuminaemia, emergency surgery, peri-operative use of steroids, and intra-abdominal sepsis. Conclusion: Intestinal anastomosis carries with it considerable mortality and the morbidity. Emergency small bowel anastomoses and intra-abdominal infection have a great risk of anastomotic leak despite attention to technical details during the procedure. Anastomotic leak rate is unaffected by the type of anastomosis performed.